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William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Thursday, July 13, 2023
Christiane K. Kuhl, MD, of RWTH Aachen University, Germany, and colleagues observed that abbreviated breast MRI detected additional invasive breast cancers that were not seen on digital breast tomosynthesis in women with breast cancer and dense breasts. Additionally, combined screening with abbreviated breast MRI and digital breast tomosynthesis yielded a low overall interval cancer rate. These findings were presented at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract 10502).
The study included women with asymptomatic average-risk and mammographically dense breasts (between the ages of 40 and 75) who were scheduled for a routine digital breast tomosynthesis screening. All women underwent digital breast tomosynthesis and abbreviated breast MRI at baseline (prevalence) and 1-year (incidence) screenings. The screenings were interpreted independently by two different radiologists blinded to the other modality.
Patients were contacted 11 to 13 months after the 1-year screening to inquire about a subsequent breast cancer diagnosis. Interval cancers reported during 11 to 13 months of follow-up until the next annual screening were included in the reference standard for sensitivity and specificity.
A total of 1,516 patients were enrolled in the study. Of them, 1,444 completed the baseline measurements, and 1,291 completed the incidence screening. During the incidence screening, nine women were diagnosed with breast cancer. Through digital breast tomosynthesis screening, cancer was detected in five women, for a cancer detection rate of 3.9 of 1,000. Through abbreviated breast MRI screening, cancer was detected in six women, four of whom had disease undetected on digital breast tomosynthesis, for a cancer detection rate of 4.6 of 1,000.
During the 2 years of study screening (baseline and year 1), there was one interval cancer, for an overall interval cancer rate of 0.37 per 1,000 person-years. The sensitivity and specificity rates were 50.0% and 98.5% for digital breast tomosynthesis compared with 60% and 93.3% for abbreviated breast MRI.
Disclosure: Dr. Kuhl reported no conflicts of interest. For full disclosures of the other study authors, visit coi.asco.org.
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