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Published in: BMC Cancer 1/2018

Open Access 01-12-2018 | Research article

Breast magnetic resonance imaging for surveillance of women with a personal history of breast cancer: outcomes stratified by interval between definitive surgery and surveillance MR imaging

Authors: Vivian Youngjean Park, Eun-Kyung Kim, Min Jung Kim, Hee Jung Moon, Jung Hyun Yoon

Published in: BMC Cancer | Issue 1/2018

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Abstract

Background

Women with a personal history of breast cancer are at increased risk of future breast cancer events, and may benefit from supplemental screening methods that could enhance early detection of subclinical disease. However, current literature on breast magnetic resonance (MR) imaging surveillance is limited. We investigated outcomes of surveillance breast magnetic resonance (MR) imaging in women with a personal history of breast cancer.

Methods

We reviewed 1053 consecutive breast MR examinations that were performed for surveillance in 1044 women (median age, 53 years; range, 20–85 years) previously treated for breast cancer between August 2014 and February 2016. All patients had previously received supplemental surveillance with ultrasound. Cancer detection rate (CDR), abnormal interpretation rate and characteristics of MR-detected cancers were assessed, including extramammary cancers. We also calculated the PPV 1 , PPV 3 , sensitivity and specificity for MR-detected intramammary lesions. Performance statistics were stratified by interval following initial surgery.

Results

The CDR for MR-detected cancers was 6.7 per 1000 examinations (7 of 1053) and was 3.8 per 1000 examinations (4 of 1053) for intramammary cancers. The overall abnormal interpretation rate was 8.0%, and the abnormal interpretation rate for intramammary lesions was 7.2%. The PPV1, PPV3, sensitivity and specificity for intramammary lesions was 5.3% (4 of 76), 15.8% (3 of 19), 75.0% (3 of 4) and 98.3% (1031 of 1049), respectively. For MR examinations performed ≤36 months after surgery, the overall CDR was 1.4 per 1000 examinations. For MR examinations performed > 36 months after surgery, the overall CDR was 17.4 per 1000 examinations.

Conclusions

Surveillance breast MR imaging may be considered in women with a history of breast cancer, considering the low abnormal interpretation rate and its high specificity. However, the cancer detection rate was low and implementation may be more effective after more than 3 years after surgery.
Literature
1.
go back to reference Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–106.CrossRefPubMed Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005;366:2087–106.CrossRefPubMed
2.
go back to reference Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378:1707–16.CrossRefPubMed Darby S, McGale P, Correa C, Taylor C, Arriagada R, Clarke M, et al. Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials. Lancet. 2011;378:1707–16.CrossRefPubMed
3.
go back to reference Khatcheressian JL, Hurley P, Bantug E, Esserman LJ, Grunfeld E, Halberg F, et al. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:961–5.CrossRefPubMed Khatcheressian JL, Hurley P, Bantug E, Esserman LJ, Grunfeld E, Halberg F, et al. Breast cancer follow-up and management after primary treatment: American Society of Clinical Oncology clinical practice guideline update. J Clin Oncol. 2013;31:961–5.CrossRefPubMed
5.
go back to reference Kuhl C, Weigel S, Schrading S, Arand B, Bieling H, Konig R, et al. Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J Clin Oncol. 2010;28:1450–7.CrossRefPubMed Kuhl C, Weigel S, Schrading S, Arand B, Bieling H, Konig R, et al. Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J Clin Oncol. 2010;28:1450–7.CrossRefPubMed
6.
go back to reference Kuhl CK, Schrading S, Leutner CC, Morakkabati-Spitz N, Wardelmann E, Fimmers R, et al. Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol. 2005;23:8469–76.CrossRefPubMed Kuhl CK, Schrading S, Leutner CC, Morakkabati-Spitz N, Wardelmann E, Fimmers R, et al. Mammography, breast ultrasound, and magnetic resonance imaging for surveillance of women at high familial risk for breast cancer. J Clin Oncol. 2005;23:8469–76.CrossRefPubMed
7.
go back to reference Sardanelli F, Podo F, Santoro F, Manoukian S, Bergonzi S, Trecate G, et al. Multicenter surveillance of women at high genetic breast cancer risk using mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (the high breast cancer risk italian 1 study): final results. Investig Radiol. 2011;46:94–105.CrossRef Sardanelli F, Podo F, Santoro F, Manoukian S, Bergonzi S, Trecate G, et al. Multicenter surveillance of women at high genetic breast cancer risk using mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (the high breast cancer risk italian 1 study): final results. Investig Radiol. 2011;46:94–105.CrossRef
8.
go back to reference Warner E, Plewes DB, Hill KA, Causer PA, Zubovits JT, Jong RA, et al. Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. JAMA. 2004;292:1317–25.CrossRefPubMed Warner E, Plewes DB, Hill KA, Causer PA, Zubovits JT, Jong RA, et al. Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. JAMA. 2004;292:1317–25.CrossRefPubMed
9.
go back to reference Ashkanani F, Sarkar T, Needham G, Coldwells A, Ah-See AK, Gilbert FJ, et al. What is achieved by mammographic surveillance after breast conservation treatment for breast cancer? Am J Surg. 2001;182:207–10.CrossRefPubMed Ashkanani F, Sarkar T, Needham G, Coldwells A, Ah-See AK, Gilbert FJ, et al. What is achieved by mammographic surveillance after breast conservation treatment for breast cancer? Am J Surg. 2001;182:207–10.CrossRefPubMed
10.
go back to reference Weinstock C, Bigenwald R, Hochman T, Sun P, Narod SA, Warner E. Outcomes Of surveillance for contralateral breast cancer in patients less than age 60 at the time of initial diagnosis. Curr Oncol. 2012;19:e160–4.CrossRefPubMedPubMedCentral Weinstock C, Bigenwald R, Hochman T, Sun P, Narod SA, Warner E. Outcomes Of surveillance for contralateral breast cancer in patients less than age 60 at the time of initial diagnosis. Curr Oncol. 2012;19:e160–4.CrossRefPubMedPubMedCentral
11.
go back to reference Cho N, Han W, Han BK, Bae MS, Ko ES, Nam SJ, et al. Breast cancer screening with mammography plus ultrasonography or magnetic resonance imaging in women 50 years or younger at diagnosis and treated with breast conservation therapy. JAMA Oncol. 2017;3:1495–502.CrossRefPubMed Cho N, Han W, Han BK, Bae MS, Ko ES, Nam SJ, et al. Breast cancer screening with mammography plus ultrasonography or magnetic resonance imaging in women 50 years or younger at diagnosis and treated with breast conservation therapy. JAMA Oncol. 2017;3:1495–502.CrossRefPubMed
12.
go back to reference Bliss JM, Kilburn LS, Coleman RE, Forbes JF, Coates AS, Jones SE, et al. Disease-related outcomes with long-term follow-up: an updated analysis of the intergroup exemestane study. J Clin Oncol. 2012;30:709–17.CrossRefPubMed Bliss JM, Kilburn LS, Coleman RE, Forbes JF, Coates AS, Jones SE, et al. Disease-related outcomes with long-term follow-up: an updated analysis of the intergroup exemestane study. J Clin Oncol. 2012;30:709–17.CrossRefPubMed
13.
go back to reference Houssami N, Ciatto S. Mammographic surveillance in women with a personal history of breast cancer: how accurate? How effective? Breast. 2010;19:439–45.CrossRefPubMed Houssami N, Ciatto S. Mammographic surveillance in women with a personal history of breast cancer: how accurate? How effective? Breast. 2010;19:439–45.CrossRefPubMed
14.
go back to reference Lu WL, Jansen L, Post WJ, Bonnema J, Van de Velde JC, De Bock GH. Impact on survival of early detection of isolated breast recurrences after the primary treatment for breast cancer: a meta-analysis. Breast Cancer Res Treat. 2009;114:403–12.CrossRefPubMed Lu WL, Jansen L, Post WJ, Bonnema J, Van de Velde JC, De Bock GH. Impact on survival of early detection of isolated breast recurrences after the primary treatment for breast cancer: a meta-analysis. Breast Cancer Res Treat. 2009;114:403–12.CrossRefPubMed
15.
go back to reference Gweon HM, Cho N, Han W, Yi A, Moon HG, Noh DY, et al. Breast MR imaging screening in women with a history of breast conservation therapy. Radiology. 2014;272:366–73.CrossRefPubMed Gweon HM, Cho N, Han W, Yi A, Moon HG, Noh DY, et al. Breast MR imaging screening in women with a history of breast conservation therapy. Radiology. 2014;272:366–73.CrossRefPubMed
16.
go back to reference Kim EJ, Kang BJ, Kim SH, Youn IK, Baek JE, Lee HS. Diagnostic performance of and breast tissue changes at early breast MR imaging surveillance in women after breast conservation therapy. Radiology. 2017;284:656–66.CrossRefPubMed Kim EJ, Kang BJ, Kim SH, Youn IK, Baek JE, Lee HS. Diagnostic performance of and breast tissue changes at early breast MR imaging surveillance in women after breast conservation therapy. Radiology. 2017;284:656–66.CrossRefPubMed
17.
go back to reference Morris E, Comstock C, Lee C. ACR BI-RADS Magnetic Resonance Imaging. In: American College of Radiology, editor. ACR BI-RADS Atlas, Breast Imaging Reporting and Data System. Reston, VA2013. Morris E, Comstock C, Lee C. ACR BI-RADS Magnetic Resonance Imaging. In: American College of Radiology, editor. ACR BI-RADS Atlas, Breast Imaging Reporting and Data System. Reston, VA2013.
18.
go back to reference Sickles EA, D'orsi CJ. ACR BI-RADS® follow-up and outcome monitoring. ACR BI-RADS® atlas breast imaging reporting and data system. Reston, VA: American college of Radiology. 2013; Sickles EA, D'orsi CJ. ACR BI-RADS® follow-up and outcome monitoring. ACR BI-RADS® atlas breast imaging reporting and data system. Reston, VA: American college of Radiology. 2013;
19.
go back to reference Brennan S, Liberman L, Dershaw DD, Morris E. Breast MRI screening of women with a personal history of breast cancer. AJR Am J Roentgenol. 2010;195:510–6.CrossRefPubMed Brennan S, Liberman L, Dershaw DD, Morris E. Breast MRI screening of women with a personal history of breast cancer. AJR Am J Roentgenol. 2010;195:510–6.CrossRefPubMed
20.
go back to reference Giess CS, Poole PS, Chikarmane SA, Sippo DA, Birdwell RL. Screening breast MRI in patients previously treated for breast cancer. Diagnostic Yield for Cancer and Abnormal Interpretation Rate Acad Radiol. 2015;22:1331–7.PubMed Giess CS, Poole PS, Chikarmane SA, Sippo DA, Birdwell RL. Screening breast MRI in patients previously treated for breast cancer. Diagnostic Yield for Cancer and Abnormal Interpretation Rate Acad Radiol. 2015;22:1331–7.PubMed
21.
go back to reference Kim MJ, Kim EK, Kwak JY, Park BW, Kim SI, Sohn J, et al. Role of sonography in the detection of contralateral metachronous breast cancer in an Asian population. AJR Am J Roentgenol. 2008;190:476–80.CrossRefPubMed Kim MJ, Kim EK, Kwak JY, Park BW, Kim SI, Sohn J, et al. Role of sonography in the detection of contralateral metachronous breast cancer in an Asian population. AJR Am J Roentgenol. 2008;190:476–80.CrossRefPubMed
22.
go back to reference Lehman CD, Lee JM, WB DM, Hippe DS, Rendi MH, Kalish G, et al. Screening MRI in women with a personal history of breast cancer. J Natl Cancer Inst. 2016;108 Lehman CD, Lee JM, WB DM, Hippe DS, Rendi MH, Kalish G, et al. Screening MRI in women with a personal history of breast cancer. J Natl Cancer Inst. 2016;108
23.
go back to reference Weinstock C, Campassi C, Goloubeva O, Wooten K, Kesmodel S, Bellevance E, et al. Breast magnetic resonance imaging (MRI) surveillance in breast cancer survivors. Spring. 2015;4:459.CrossRef Weinstock C, Campassi C, Goloubeva O, Wooten K, Kesmodel S, Bellevance E, et al. Breast magnetic resonance imaging (MRI) surveillance in breast cancer survivors. Spring. 2015;4:459.CrossRef
24.
go back to reference Kuhl CK, Strobel K, Bieling H, Leutner C, Schild HH, Schrading S. Supplemental breast MR imaging screening of women with average risk of breast cancer. Radiology. 2017;283:361–70.CrossRefPubMed Kuhl CK, Strobel K, Bieling H, Leutner C, Schild HH, Schrading S. Supplemental breast MR imaging screening of women with average risk of breast cancer. Radiology. 2017;283:361–70.CrossRefPubMed
25.
go back to reference Berg WA, Zhang Z, Lehrer D, Jong RA, Pisano ED, Barr RG, et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA. 2012;307:1394–404.CrossRefPubMedPubMedCentral Berg WA, Zhang Z, Lehrer D, Jong RA, Pisano ED, Barr RG, et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. JAMA. 2012;307:1394–404.CrossRefPubMedPubMedCentral
27.
go back to reference Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Bohm-Velez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA. 2008;299:2151–63.CrossRefPubMedPubMedCentral Berg WA, Blume JD, Cormack JB, Mendelson EB, Lehrer D, Bohm-Velez M, et al. Combined screening with ultrasound and mammography vs mammography alone in women at elevated risk of breast cancer. JAMA. 2008;299:2151–63.CrossRefPubMedPubMedCentral
28.
go back to reference Kim HJ, Kwak JY, Choi JW, Bae JH, Shin KM, Lee HJ, et al. Impact of US surveillance on detection of clinically occult locoregional recurrence after mastectomy for breast cancer. Ann Surg Oncol. 2010;17:2670–6.CrossRefPubMed Kim HJ, Kwak JY, Choi JW, Bae JH, Shin KM, Lee HJ, et al. Impact of US surveillance on detection of clinically occult locoregional recurrence after mastectomy for breast cancer. Ann Surg Oncol. 2010;17:2670–6.CrossRefPubMed
29.
go back to reference Lee JH, Kim EK, Oh JY, Kwon HC, Kim SH, Kim DC, et al. US screening for detection of nonpalpable locoregional recurrence after mastectomy. Eur J Radiol. 2013;82:485–9.CrossRefPubMed Lee JH, Kim EK, Oh JY, Kwon HC, Kim SH, Kim DC, et al. US screening for detection of nonpalpable locoregional recurrence after mastectomy. Eur J Radiol. 2013;82:485–9.CrossRefPubMed
30.
go back to reference Suh YJ, Kim MJ, Kim EK, Moon HJ, Kim SI, Park BW. Value of ultrasound for postoperative surveillance of asian patients with history of breast cancer surgery: a single-center study. Ann Surg Oncol. 2013;20:3461–8.CrossRefPubMed Suh YJ, Kim MJ, Kim EK, Moon HJ, Kim SI, Park BW. Value of ultrasound for postoperative surveillance of asian patients with history of breast cancer surgery: a single-center study. Ann Surg Oncol. 2013;20:3461–8.CrossRefPubMed
Metadata
Title
Breast magnetic resonance imaging for surveillance of women with a personal history of breast cancer: outcomes stratified by interval between definitive surgery and surveillance MR imaging
Authors
Vivian Youngjean Park
Eun-Kyung Kim
Min Jung Kim
Hee Jung Moon
Jung Hyun Yoon
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2018
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-018-3998-1

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