Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features

Gilbert, Fiona J., Warren, Ruth M. L., Kwan-Lim, Gek, Thompson, Deborah J., Eeles, Ros A., Evans, D. Gareth, Leach, Martin O., United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group and Lakhani, S. R. (2009) Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features. Radiology, 252 2: 358-368. doi:10.1148/radiol.2522081032


Author Gilbert, Fiona J.
Warren, Ruth M. L.
Kwan-Lim, Gek
Thompson, Deborah J.
Eeles, Ros A.
Evans, D. Gareth
Leach, Martin O.
United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group
Lakhani, S. R.
Title Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features
Formatted title
Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features
Journal name Radiology   Check publisher's open access policy
ISSN 0033-8419
1527-1315
Publication date 2009-08
Sub-type Article (original research)
DOI 10.1148/radiol.2522081032
Volume 252
Issue 2
Start page 358
End page 368
Total pages 11
Place of publication Oak Brook, IL, United States
Publisher Radiological Society of North America
Language eng
Formatted abstract
Purpose: To review imaging features of screening-detected cancers on images from diagnostic and prior examinations to identify specific abnormalities to aid earlier detection of or facilitate differentiation of cancers in BRCA1 and BRCA2 carriers and in women with a high risk for breast cancer.

Materials and Methods: Informed consent and multicenter and local research ethics committee approval were obtained. Women (mean age, 40.1 years; range, 27–55 years) who had at least a 50% risk of being a BRCA1, BRCA2, or TP53 gene mutation carrier were recruited from August 1997 to March 2003 into the United Kingdom Magnetic Resonance Imaging in Breast Screening Study Group trial and were offered annual magnetic resonance (MR) imaging and two-view mammography (total number of screenings, 2065 and 1973; mean, 2.38 and 2.36, respectively). Images in all 39 cancer cases were reread in consensus to document the morphologic and enhancement imaging features on MR and mammographic images in screening and prior examinations. Cases were grouped into genetic subtypes.

Results: With MR imaging, there was no difference in morphologic or enhancement characteristics between the genetic subgroups. Cancers on images from prior examinations were of smaller size, showed less enhancement, and were more likely to have a type 1 enhancement curve compared with those cancers in the subsequent diagnostic screening examinations. The tumor sizes detected by using MR imaging and mammography were not significantly different (P = .46). The cancers in BRCA1 carriers found by using MR imaging tended to be smaller than those detected by using mammography (median, 17 mm vs 30 mm; P = .37), whereas the opposite was true for cancers found in BRCA2 carriers (MR imaging median size = 12.5 mm vs mammographic median size = 6 mm; P = .067); the difference was not significant. Tumors with prior MR imaging abnormalities grew at an average of 5.1 mm/y.

Conclusion: When undertaking MR imaging surveillance in high-risk women, small enhancing lesions should be regarded with suspicion and biopsied or patients should be followed up at 6 months.
Keyword High familial risk
Mutation carriers
Estrogen-receptor
Multicenter
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
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