Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition
Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition
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DOI：
10.1056/nejmoa031759
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发表时间：
2004-07-29
影响因子：
158.5
通讯作者：
Klijn, JGM
中科院分区：
文献类型：
--
作者：
Kriege, M;Brekelmans, CTM;Klijn, JGM
背景：对有乳腺癌遗传或家族易感性的女性进行定期监测的价值目前尚未得到证实。我们比较了磁共振成像（MRI）与乳腺X线摄影筛查在这组高危women.METHODS的有效性：乳腺癌的累积终生风险为15%或以上的妇女进行筛查，每六个月进行一次临床乳腺检查，每年进行一次乳腺X线摄影和MRI，独立读数。被检测到的癌症的特征进行了比较，在两个不同的年龄匹配的对照组的特征。结果：我们筛选了1909名合格的妇女，包括358个携带者的生殖系突变。在平均2.9年的随访期内，检测到51个肿瘤（44个浸润性癌，6个导管原位癌和1个淋巴瘤）和1个小叶原位癌。临床乳腺检查、钼靶摄影和MRI检测浸润性乳腺癌的敏感性分别为17.9%、33.3%和79.5%，特异性分别为98.1%、95.0%和89.8%。MRI对乳腺癌的总体鉴别能力明显优于钼靶X线（P
BACKGROUND:The value of regular surveillance for breast cancer in women with a genetic or familial predisposition to breast cancer is currently unproven. We compared the efficacy of magnetic resonance imaging (MRI) with that of mammography for screening in this group of high-risk women.METHODS:Women who had a cumulative lifetime risk of breast cancer of 15 percent or more were screened every six months with a clinical breast examination and once a year by mammography and MRI, with independent readings. The characteristics of the cancers that were detected were compared with the characteristics of those in two different age-matched control groups.RESULTS:We screened 1909 eligible women, including 358 carriers of germ-line mutations. Within a median follow-up period of 2.9 years, 51 tumors (44 invasive cancers, 6 ductal carcinomas in situ, and 1 lymphoma) and 1 lobular carcinoma in situ were detected. The sensitivity of clinical breast examination, mammography, and MRI for detecting invasive breast cancer was 17.9 percent, 33.3 percent, and 79.5 percent, respectively, and the specificity was 98.1 percent, 95.0 percent, and 89.8 percent, respectively. The overall discriminating capacity of MRI was significantly better than that of mammography (P