Breast MRI Screening of Women With a Personal History of Breast Cancer
Breast MRI Screening of Women With a Personal History of Breast Cancer
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DOI：
10.2214/ajr.09.3573
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发表时间：
2010-08-01
影响因子：
5
通讯作者：
Morris, Elizabeth
中科院分区：
文献类型：
--
作者：
Brennan, Sandra;Liberman, Laura;Morris, Elizabeth
目标。本文的目的是确定仅根据个人乳腺癌病史进行乳房MRI筛查的妇女的癌症检出率和活检率。材料和方法。这项回顾性研究对1999年至2001年间进行的1,699次乳房MRI检查进行了回顾，其中144名女性患有乳腺癌，但没有家族史，她们在此期间开始了乳房MRI筛查。最小乳腺癌被定义为导管原位癌（DCIS）或小于1cm的淋巴结阴性浸润性乳腺癌。144名女性中，有44名（31% [95% CI, 15-29%]）在MRI检查的提示下接受了活检。活组织检查显示17例（12% [95% CI, 7-18%]）为恶性肿瘤，27例（19% [95% CI, 13-26%]）为良性肿瘤。在被检测出癌症的17名女性中，有7名活检结果为良性。共发现18例恶性肿瘤。一名妇女患有两种异时性癌症。MRI筛查共导致61例活检，阳性预测值（PPV）为39% （95% CI, 27-53%）。恶性肿瘤包括17个癌和1个黏液样脂肪肉瘤。在17例癌症中，12例（71%）为浸润性，5例（29%）为DCIS， 10例（59%）为轻度乳腺癌。在17例癌症中，10例仅通过MRI检测到。仅MRI检出的10例乳腺癌，较其他方法检出的7例更有可能为DCIS（4/10[40%]比1/7 [14%]，p = 0.25）或轻度乳腺癌（7/10[70%]比3/7 [43%]，p = 0.26）。我们发现，只有乳腺癌个人病史的女性进行乳腺MRI筛查，发现恶性肿瘤的临床价值为12%，活检率合理（PPV, 39%）。
OBJECTIVE. The purpose of this article is to determine the cancer detection and biopsy rate among women who have breast MRI screening solely on the basis of a personal history of breast cancer.MATERIALS AND METHODS. This retrospective review of 1,699 breast MRI examinations performed from 1999 to 2001 yielded 144 women with prior breast cancer but no family history who commenced breast MRI screening during that time. Minimal breast cancer was defined as ductal carcinoma in situ (DCIS) or node-negative invasive breast cancer < 1 cm in size.RESULTS. Of 144 women, 44 (31% [95% CI, 15-29%]) underwent biopsies prompted by MRI examination. Biopsies revealed malignancies in 17 women (12% [95% CI, 7-18%]) and benign findings only in 27 women (19% [95% CI, 13-26%]). Of the 17 women in whom cancer was detected, seven also had benign biopsy results. In total, 18 malignancies were found. One woman had two metachronous cancers. MRI screening resulted in a total of 61 biopsies, with a positive predictive value (PPV) of 39% (95% CI, 27-53%). The malignancies found included 17 carcinomas and one myxoid liposarcoma. Of the 17 cancers, 12 (71%) were invasive, five (29%) were DCIS, and 10 (59%) were minimal breast cancers. Of 17 cancers, 10 were detected by MRI only. The 10 cancers detected by MRI only, versus seven cancers later found by other means, were more likely to be DCIS (4/10 [40%] vs 1/7 [14%]; p = 0.25) or minimal breast cancers (7/10 [70%] vs 3/7 [43%]; p = 0.26).CONCLUSION. We found that breast MRI screening of women with only a personal history of breast cancer was clinically valuable finding malignancies in 12%, with a reasonable biopsy rate (PPV, 39%).