Comparison of breast magnetic resonance imaging, mammography, and ultrasound for surveillance of women at high risk for hereditary breast cancer
Comparison of breast magnetic resonance imaging, mammography, and ultrasound for surveillance of women at high risk for hereditary breast cancer
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DOI：
10.1200/jco.2001.19.15.3524
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发表时间：
2001-08-01
影响因子：
45.3
通讯作者：
Narod, SA
中科院分区：
文献类型：
--
作者：
Warner, E;Plewes, DB;Narod, SA
目的：对BRCA1和BRCA2突变携带者的推荐监测包括定期乳房X光检查和临床乳房检查，尽管这些筛查技术在突变携带者中的有效性尚未确定。本研究的目的是比较乳腺磁共振成像（MRI）与超声、乳房X线摄影和体格检查在遗传性乳腺癌高危女性中的作用。共有196名年龄在26岁至59岁之间的女性接受了乳房X光检查、超声检查、MRI检查，和临床乳房检查。活检时，任何四个调查被判断为可疑malignancy.Results：六个浸润性乳腺癌和一个非浸润性乳腺癌中检测到的196个高危妇女。其中五种侵袭性癌症发生在突变携带者身上，第六种发生在有乳腺癌病史的女性身上。96例突变携带者中浸润性或非浸润性乳腺癌的患病率为6.2%。所有6例浸润性癌均通过MRI检测到，直径均为1.0 cm或更小，且均为淋巴结阴性。相比之下，只有三个浸润性癌症被超声检测到，两个通过乳房X光检查，两个通过体检。除了MRI的更常见的三位一体的乳房X线摄影，超声和乳腺检查确定了两个额外的浸润性乳腺癌，否则会missed.Conclusion：乳腺MRI可能是上级乳房X线摄影和超声筛查的妇女在遗传性乳腺癌的高风险。
Purpose: Recommended surveillance for BRCA1 and BRCA2 mutation carriers includes regular mammography and clinical breast examination, although the effectiveness of these screening techniques in mutation carriers has not been established. The purpose of the present study was to compare breast magnetic resonance imaging (MRI) with ultrasound, mammography, and physical examination in women at high risk for hereditary breast cancer.Patients and Methods: A total of 196 women, aged 26 to 59 years, with proven BRCA1 or BRCA2 mutations or strong family histories of breast or ovarian cancer underwent mammography, ultrasound, MRI, and clinical breast examination on a single day. A biopsy was performed when any of the four investigations was judged to be suspicious for malignancy.Results: Six invasive breast cancers and one noninvasive breast cancer were detected among the 196 high-risk women. Five of the invasive cancers occurred in mutation carriers, and the sixth occurred in a woman with a previous history of breast cancer. The prevalence of invasive or noninvasive breast cancer in the 96 mutation carriers was 6.2%. All six invasive cancers were detected by MRI, all were 1.0 cm or less in diameter, and all were node-negative. In contrast, only three invasive cancers were detected by ultrasound, two by mammography, and two by physical examination. The addition of MRI to the more commonly available triad of mammography, ultrasound, and breast examination identified two additional invasive breast cancers that would otherwise have been missed.Conclusion: Breast MRI may be superior to mammography and ultrasound for the screening of women at high risk for hereditary breast cancer.