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Abstract

Purpose: The purpose of this study is to evaluate the diagnostic value of biannual dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) regarding the early detection of breast cancer in women at elevated risk. Materials and Methods: A retrospective review was performed of the records of 232 asymptomatic women at elevated risk for breast cancer (mean age at entry: 44 years; range: 22-73 years). A total of 1440 biannual DCE-MRI rounds and 802 annual screening mammography rounds from 2002 to 2014 were reviewed. All lesions were detected as abnormal enhancing findings on a dynamic contrast enhanced MRI and subsequently biopsied. Pathology findings were then correlated with imaging to ensure concordance. Results: A total of 33 biopsies were performed on 31 high risk women (PPV2: 21%). As a result, 7 cancers (21%) and 26 benign lesions (79%) were detected (PPV3: 21%). Of the detected cancers (2 DCIS and 5 IDC), 0 were axillary node positive. Mean size of detected invasive cancer was 0.7 cm (range: 0.4�1.1 cm) and the most common imaging appearance was an enhancing mass (86%). Of these cancers, 5 (71%) were detected in patients with a personal history of cancer and 6 (86%) were in non-baseline examinations. All 7 cancers were detected on DCE-MRI, 4 of which were seen only on DCE-MRI (56%). Conclusions: Biannual screening DCE-MRI can serve as an effective surveillance tool in high-risk women, particularly for the detection of small, node-negative breast cancers. Biannual screening DCE-MRI may allow for the detection of smaller cancers than with annual screening DCE-MRI.

Biography

Email: DSheth@radiology.bsd.uchicago.edu