Breast Cancer Screening in Women With Familial Risk: MRI or Mammography?
Posted: Wednesday, September 11, 2019
According to the Dutch FaMRIsc randomized controlled trial, magnetic resonance imaging (MRI) screening of women at high risk of developing breast cancer led to earlier detection of breast cancer, and fewer late-stage cancers, than mammography. These findings were published in The Lancet Oncology by Sepideh Saadatmand, MD, of Erasmus University Medical Center in the Netherlands, and colleagues. According to the investigators, early detection with MRI screening may reduce the need for adjuvant chemotherapy and the risk of mortality.
“Our findings can be used to inform policy discussions about the implementation of MRI in high-risk breast screening,” they noted.
There were 1,355 participants in the trial: 657 in the MRI group and 680 in the mammography group. All patients had at least a 20% familial predisposition to breast cancer.
MRI detected 40 breast cancers versus 15 by mammography. In the MRI group, 24 invasive cancers were detected versus 8 in the mammography group. Of those cancers, the ones detected by MRI were smaller, with a median size of 9 mm versus 17 mm in the ones detected by mammography. Tumor stage detection was earlier in the MRI group, with 12 of 25 tumors (48%) identified at T1a and T1b versus 1 of 15 tumors (7%) in the mammography group.
According to the authors, disadvantages associated with MRI were more false-positive results and overdiagnosis. The incidence of all cancers detected was higher in the MRI group than in the mammography group.
“In real-life practice, MRI screening can result in an important and favorable shift in tumor stage at [the] time of breast cancer detection compared with mammography screening,” the researchers concluded.
Disclosure: The study authors reported no conflicts of interest.
