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William J. Gradishar, MD, FACP, FASCO


Study Finds Breast Tissue Features on MRI May Be Linked to Risk for Second Breast Cancer

By: Anna Fanelli
Posted: Monday, October 24, 2022

A study in the journal Radiology investigated whether breast tissue features at surveillance MRI may be associated with subsequent second breast cancer risk in women with a history of the disease. More specifically, Su Hyun Lee, MD, PhD, of Seoul National University Hospital, Korea, and colleagues studied the link between second cancer risk and background parenchymal enhancement at surveillance breast MRI.

“Our study results may help to stratify the risk of second breast cancer in women with a personal history of breast cancer and to establish personalized imaging surveillance strategies in terms of imaging modality and monitoring interval selection,” said Dr. Lee in a Radiological Society of North America (RSNA) press release. “For example, women with minimal [background parenchymal enhancement] at surveillance breast MRI may no longer need to undergo contrast-enhanced breast MRI every year if other risk factors are absent.”

A retrospective search of the imaging database of an academic medical center identified consecutive surveillance breast MRI examinations performed between January 2008 and December 2017 in women who underwent surgery for primary breast cancer and had no prior diagnosis of second breast cancer. Future second breast cancer was defined as ipsilateral breast tumor recurrence or contralateral breast cancer diagnosed at least 1 year after each surveillance breast MRI examination. Factors associated with future second breast cancer risk were evaluated using the multivariable Fine-Gray subdistribution hazard model.

Among 2,668 women in the study, 109 developed a second breast cancer at a median follow-up of 5.8 years. Mild, moderate, or marked background parenchymal enhancement at surveillance breast MRI was independently associated with an increased risk of future second breast cancer compared with minimal background parenchymal enhancement.

Therefore, Dr. Lee and colleagues expect that risk models will use mammography, ultrasound, and MRI together. This approach may lead to more tailored surveillance strategies for women with a history of breast cancer.

Disclosure: The study authors reported no conflicts of interest.

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