Identifying Cancer in Dense Breasts: Abbreviated MRI Versus 3D Mammography
Posted: Tuesday, July 14, 2020
Digital breast tomosynthesis, also known as 3D mammography, appears to be limited in its ability to detect cancer in dense breast tissue, even though half of women older than age 40 have dense breast tissue. Although breast MRI is an effective alternative, it also has drawbacks, including expense and lengthy duration. According to Christopher E. Comstock, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues, abbreviated breast MRI is associated with a higher rate of invasive cancer detection than 3D mammography. The findings of their cross-sectional, longitudinal study were published in JAMA.
“Abbreviated breast MRI is a 10-minute test that reduces the complexity and cost of MRI by shortening the time it takes to perform and interpret the exam,” commented Dr. Comstock in an ECOG-ACRIN Cancer Research Group press release.
The study took place over 47 centers in the United States and 1 in Germany, with a total of 1,444 patients screened. Study participants were comprised of women between the ages of 40 and 75 without breast cancer or symptoms and who had dense breast tissue on a previous mammogram. Each patient was screened with both 3D mammography and abbreviated MRI within a 24-hour period, and they were then screened again after 12 months.
In the first year of the study, a total of 17 women were diagnosed with invasive cancer and 6, with ductal carcinoma in situ. Of these cancers, 22 were detected by abbreviated MRI and 9, with 3D mammography. One case of ductal carcinoma in situ was detected by 3D mammography but not abbreviated MRI. Additionally, slightly more false-positive results were detected by abbreviated MRI. No patients were diagnosed with interval cancers at follow-up.
“While these early results are promising, further studies are needed to evaluate the cost-effectiveness of widespread screening with abbreviated breast MRI and its impact on reducing breast cancer mortality,” further noted Dr. Comstock.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.