Magnetic Resonance Imaging for Screening of Woman at High-Risk of Breast Cancer

Reham G. Garout, Howayda M. Ahmed, Saddig D. Jastaniah, Ibrahim A. Awad

Department of Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, KSA.

DOI: 10.4236/abcr.2014.33009                

Abstract

MRI is an excellent option for detection of breast cancer for some selected groups, including those patients with a high probability to hit the disease. However, the high costs and low availability of the device have led to a decline in the application of imaging MRI. The aim of this study was to review usefulness of MRI as a new complementary way to detect breast cancer in routine annual checkup for women breasts of certain ages and breast mass. A cross-sectional Descriptive MRI study was performed on 105 asymptomatic women with a mean age of 49 years. The study group with at least one risk factor of breast cancer were presenting for routine annual screening or follow up at King Abdulaziz University Hospital in Jeddah. It has been found that, 48 patients had biopsy, they were recommended by magnetic resonance imaging and only 14 had positive results, while magnetic resonance imaging suggested 16 and mammography had 62 positive results. Magnetic resonance imaging is not recommended for the average-risk or the general population either; it had been advised for screening the high-risk women of breast cancer. Sensitivity of magnetic resonance imaging has been found to be much higher than of mammography but specificity was generally lower. We propose that it is reasonable to consider MRI as a complement to mammography in screening patients who were at high risk for breast cancer because Magnetic Resonance Imaging can detect small foci that are occult in mammography but we don’t advise to check with the general population.

Keywords

MRI, Mammogram, Breast Cancer, Women Breasts

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Lehman, C. (2006) Role of MRI in Screening Women at High Risk for Breast Cancer. Journal of Magnetic Resonance Imaging, 24, 964-970. http://dx.doi.org/10.1002/jmri.20752
[2]	Lehman, C., Blume, J., Weatherall, P., Thickman, D., Hylton, N., Warner, E., et al. (2005) Screening Women at High Risk for Breast Cancer with Mammography and Magnetic Resonance Imaging. Cancer, 103, 1898-1905. http://dx.doi.org/10.1002/cncr.20971
[3]	Dummin, L.J., Cox, M. and Plant, L. (2007) Prediction of Breast Tumour Size by Mammography and Sonography—A Breast Screen Experience. The Breast Journal, 16, 38-46. http://dx.doi.org/10.1016/j.breast.2006.04.003
[4]	Berg, W., Zhang, Z., Lehrer, D., Jong, R., Pisano, E., Barr, R., et al. (2012) Detection of Breast Cancer with Addition of Annual Screening Ultrasound of a Single Screening MRI to Mammography in Women with Elevated Breast Cancer Risk. JAMA, 307, 1394-1404. http://dx.doi.org/10.1001/jama.2012.388
[5]	Gavenonis, S. (2011) Breast MR Imaging: Normal Anatomy. In: Liu, P.S., Ed., Normal MRI Anatomy from Head to Toe, an Issue of Magnetic Resonance Imaging Clinics, 1st Edition, Saunders Publisher, 519-507.
[6]	Malur, S., Wurdinger, S., Moritz, A., Michels, W. and Schneide, R. (2001) A Comparison of Written Reports of Mammography, Sonography and Magnetic Resonance Mammography for Preoperative Evaluation of Breast Lesions, with Special Emphasis on Magnetic Resonance Mammography. Breast Cancer Research, 3, 55-60. http://dx.doi.org/10.1186/bcr271
[7]	American Cancer Society (2013) What Are the Risk Factors for Breast Cancer? http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-risk-factors
[8]	Afonso, N. (2009) Women at High Risk for Breast Cancer—What the Primary Care Provider Needs to Know. JABFM, 22, 43-50. http://dx.doi.org/10.3122/jabfm.2009.01.070188
[9]	Sasieni, P., Shelton, J., Ormiston-smith, N., Thomson, C. and Silcocks, P. (2011) Among What Is the Life Time Risk o Developing Cancer? British Journal of Cancer, 11, 460-465.
[10]	Urban, L. and Urban, C. (2012) Role of Mammography versus Magnetic Resonance Imaging for Breast Cancer Screening. Current Breast Cancer Reports, 4, 216-223 http://dx.doi.org/10.1007/s12609-012-0085-5
[11]	Kriege, M., Brekelmans, C.T., Boetes, C., et al. (2004) Efficacy of MRI and Mammography for Breast-Cancer Screening in Women with a Familial or Genetic Predisposition. The New England Journal of Medicine, 351, 427-437. http://dx.doi.org/10.1056/NEJMoa031759
[12]	Warner, E., Plewes, D.B., Hill, K.A., et al. (2004) Surveillance of BRCA1 and BRCA2 Mutation Carriers with Magnetic Resonance Imaging, Ultrasound, Mammography, and Clinical Breast Examination. JAMA, 292, 1317-1325. http://dx.doi.org/10.1001/jama.292.11.1317
[13]	Morris, E., Liberman, L., Ballon, D.J., et al. (2003) MRI of Occult Breast Carcinoma in a High-Risk Population. AJR Am J Roentgenol, 181, 619-626. http://dx.doi.org/10.2214/ajr.181.3.1810619
[14]	Orel, S.G. and Schnall, M.D. (2001) MR Imaging of the Breast for the Detection, Diagnosis, and Staging of Breast Cancer. Radiology, 220, 13-30. http://dx.doi.org/10.1148/radiology.220.1.r01jl3113
[15]	Elmore, J., Armstrong, K., Lehman, C. and Fletcher, S. (2005) Screening for Breast Cancer. JAMA, 293, 1245-1256. http://dx.doi.org/10.1001/jama.293.10.1245
[16]	Forrai, G. (2011) Magnetic Resonance Imaging (MRI) in the Screening of High-Risk Patients and in the Detection and Diagnosis of Early Breast Cancer. In: Kahán, Z. and Tot, T., Eds., Breast Cancer, a Heterogeneous Disease Entity, Springer, 55-45. http://dx.doi.org/10.1007/978-94-007-0489-3_3
[17]	Saslow, D., Boetes, C., Burke, W., Harms, S., Leach, M. and Lehman, C. (2007) American Cancer Society Guidelines for Breast Screening with MRI as an Adjunct to Mammography. CA: A Cancer Journal for Clinicians, 57, 75-89. http://dx.doi.org/10.3322/canjclin.57.2.75