Screening women at high risk for breast cancer with mammography and magnetic resonance imaging
Screening women at high risk for breast cancer with mammography and magnetic resonance imaging
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DOI：
10.1002/cncr.20971
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发表时间：
2005-05-01
期刊：
影响因子：
6.2
通讯作者：
Schnall, M
中科院分区：
文献类型：
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作者：
Lehman, CD;Blume, JD;Schnall, M
背景作者比较了筛查性乳腺X线摄影与磁共振成像（MRI）在乳腺癌遗传高危女性中的表现。作者在年龄≥ 25岁的无症状、遗传高危女性中进行了一项筛查性乳腺X线摄影和MRI的国际前瞻性研究。有乳腺癌病史的妇女，如果在5年内被诊断，则有资格进行对侧筛查，如果在5年前被诊断，则有资格进行双侧筛查。所有检查（MRI、乳腺X线摄影和临床乳腺检查[CBE]）均在90天内进行。总共有390名符合条件的女性在13个研究中心入组，367名女性完成了所有研究检查。影像学评价建议进行38次活检，进行了27次活检，诊断出4例癌症，总癌症率为1.1%（95%置信区间[95%CI]，0.3-2.8%）。MRI检测到所有四种癌症，而乳房X光检查检测到一种癌症。乳腺X线摄影的诊断率为0.3%（95%CI，0.01-1.5%）。仅MRI检查的癌症检出率为0.8%（95%CI，-0.3-2.0%）。MRI和乳腺X线检查的活检推荐率分别为8.5%（95%CI，5.8-11.8%）和2.2%（95%CI，0.1-4.3%）。在高危女性中进行MRI筛查能够检测到乳房X线检查和临床隐匿性乳腺癌。筛查MRI导致367名乳腺X线检查阴性和CBE检查阴性的女性中有22名（6%）接受活检，导致检测到3种额外的癌症。MRI还导致19例（5%）假阳性结果，导致良性活检。(c)2005年美国癌症协会。
BACKGROUND. The authors compared the performance of screening mammography versus magnetic resonance imaging (MRI) in women at genetically high risk for breast cancer.METHODS. The authors conducted an international prospective study of screening mammography and MRI in asymptomatic, genetically high-risk women age >= 25 years. Women with a history of breast cancer were eligible for a contralateral screening if they had been diagnosed within 5 years or a bilateral screening if they had been diagnosed > 5 years previously. All examinations (MRI, mammography, and clinical breast examination [CBE]) were performed within 90 days of each other.RESULTS. In total, 390 eligible women were enrolled by 13 sites, and 367 women completed all study examinations. Imaging evaluations recommended 38 biopsies, and 27 biopsies were performed, resulting in 4 cancers diagnosed for an overall 1.1% cancer yield (95% confidence interval [95%CI], 0.3-2.8%). MRI detected all four cancers, whereas mammography detected one cancer. The diagnostic yield of mammography was 0.3% (95%CI, 0.01-1.5%). The yield of cancer by MRI alone was 0.8% (95%CI, - 0.3-2.0%). The biopsy recommendation rates for MRI and mammography were 8.5% (95%CI, 5.8-11.8%) and 2.2% (95%CI, 0.1-4.3%).CONCLUSIONS. Screening MRI in high-risk women was capable of detecting mammographically and clinically occult breast cancer. Screening MRI resulted in 22 of 367 of women (6%) who had negative mammogram and negative CBE examinations undergoing biopsy, resulting in 3 additional cancers detected. MRI also resulted in 19 (5%) false-positive outcomes, which resulted in benign biopsies. (c) 2005 American Cancer Society.