It has been shown that women with previous breast cancer who have undergone MRI screening have a lower incidence of new cancers, compared with women who have no history of breast cancer. The study also found that MRI screening was significantly superior to ultrasonography and mammography for detecting invasive and non-invasive cancers. In addition, the study showed that MRI screening increased recall rate, biopsy rate, and short-term follow-up rate.
MRI sensitivity was 79.4% for all cancers and 88.5% for invasive cancers
MRI of the breast has the highest sensitivity for cancer detection. Unlike mammography, it can also detect smaller tumors and multiple nodes. However, it is not recommended as a primary screening test for women at average risk. It is typically offered to women who are at high risk for developing breast cancer.
A study by Lehman and colleagues evaluated the utility of MRI in detecting breast cancer. They compared the results of a multi-centric MRI to those of a conventional MRI and clinical examination. The results showed that MRI had higher sensitivity in invasive cancer and mammographically occult cancers. But it had lower sensitivity in the early stage of breast cancer.
The investigators used an abbreviated dynamic contrast-enhanced (DCE)-MRI protocol to improve image acquisition and interpretation time. This reduced MRI costs and provided high diagnostic accuracy.
Despite its superior sensitivity, the authors were unable to determine whether MRI of the breast is associated with increased disease-free survival. In addition, they could not assess the cost effectiveness of MRI.
One major drawback of the study is that it was conducted at one institution. Moreover, it was not designed to be a multicenter study. These limitations limit the generalizability of the findings. Moreover, researchers did not investigate whether the effect of T2WI on false-positive findings was related to the occurrence of incidental breast lesions.
Overall, the study concluded that MRI is a useful adjunct to mammography for identifying early stage breast cancer. Nevertheless, further studies are needed to determine the effects of MRI on clinical outcome.
For high-risk patients, MRI has potential as a post-treatment surveillance tool. Its high sensitivity can detect high-grade tumors that might be missed by mammography. MRI is also helpful in detecting synchronous contralateral disease.
Despite its excellent sensitivity, the literature is sparse on the utility of MRI in detecting secondary malignancies. Some research has indicated that MRI might be a valuable screening tool for women at increased risk for developing secondary malignancies. Consequently, it might replace conventional imaging in these patients.
Although MRI has been used as an adjunct to mammography for detecting atypical hyperplasia and small node-negative tumors, there are limited data on its effectiveness in detecting early-stage breast cancer.
MRI performance is superior in women with PH compared with women with GFH
MRI is an effective screening modality for breast cancer. However, MRI is not recommended for routine surveillance of nipple discharge. In addition, MRI is not associated with the earlier stages of detection. The performance of MRI is not well documented. Therefore, further studies are needed to determine the long-term impact of MRI on the clinical and psychosocial aspects of breast cancer.
Abbreviated MRI is a short, noninvasive, inexpensive, and quick diagnostic test that may soon be a routine screening tool for secondary cancer. It also has a high recall rate. It has been shown to detect node-negative T1 tumors. A randomized trial is needed to evaluate the long-term effect of MRI on breast cancer patients.
Compared to mammography, MRI is more accurate in detecting breast cancer. This is due to its higher sensitivity and its ability to detect smaller, more aggressive tumors. Moreover, abbreviated MRI is a useful tool to screen breast cancer survivors.
There is insufficient data on the use of MRI to support annual screening for women of average risk. However, MRI has a superior sensitivity to mammography in detecting invasive breast cancer. In addition, MRI is able to detect cancer in the contralateral breast. For women of high risk, MRI is a valuable adjunct to conventional imaging.
According to Park and colleagues, breast MRI surveillance in women with PH of breast cancer can be an effective method for identifying recurrences. They reviewed 1,053 consecutive MRI examinations. Interestingly, they found that abMRI has a higher PPV than MMG or US. Additionally, abMRI was more sensitive than MMG or US.
The PPV was 8% to 39 percent when using low-field equipment. For high-field equipment, the PPV was 19 percent. But the most important statistic is that abMRI performed better than MMG and US.
To determine whether abMRI is the best possible screening modality for breast cancer, An and co-workers conducted a systematic review. They also performed a meta-analysis. Their results suggest that abMRI could be used to replace conventional imaging in breast cancer survivors.
The study was conducted in a single center. However, there are still many questions about the diagnostic process, including the optimal reading protocol.
MRI increases recall rate, biopsy rate, and short-term follow-up rate after addition of ultrasonography to mammography
Magnetic resonance imaging (MRI) is a highly sensitive technique that has become popular as a breast cancer screening method. It has been used to detect small node-negative and invasive cancers. However, there are a number of questions that need to be answered before MRI can be deemed safe and effective for routine use. In addition to the question of what is the best way to integrate MRI into routine breast cancer screening, a variety of clinical and psychosocial factors need to be considered.
A study was conducted to determine whether MRI can increase recall rate, biopsy rate, and short-term follow-up rate after the addition of ultrasonography (US) to mammography. The study included a group of women who underwent a breast MRI at the request of their clinicians.
For those who underwent both mammography and US, MRI had a high sensitivity but a lower specificity than mammography alone. Although the overall sensitivity was comparable, the PPV was greater for MRI devices with more than 1.5 Tesla. Moreover, the sensitivity of MRI in the contralateral breast was higher than mammography, with a PPV of 29 to 53 %.
Among the patients in the MR imaging group, the mean pathological size of the index tumor was 10.9 mm. This was comparable to the pT2 tumor size in the no MRI group. Moreover, there was no significant difference in the proportion of patients with pathologically localized disease, which was 82.9 % in the no MRI group.
Furthermore, the reoperation rate was similar between the groups. Patients in the no MRI group underwent a reoperation less often than in the MRI group. There was no significant difference in the number of patients who had mammographically occult cancers.
After addition of MRI to mammography, the cancer detection rate increased to 4.4 per 1,000 examinations. The abnormal interpretation rate was 8.0 percent. Additionally, the cancer detection rate was 3.8 per 1,000 examinations for intra-mammary cancers. Using this method, MRI detected clinically occult cancer in the contralateral breast in 30 of 969 women.
A small number of patients with true-positive MRI findings underwent more radical surgery, whereas a larger proportion of patients with true-positive findings did not have cancer. While MRI can be an adjunct to mammography in detecting and assessing invasive and mammographically occult cancer, randomized trials are needed to determine whether MRI actually reduces re-excision rates or improves overall survival.
Cost-effectiveness analysis can play an important role in determining the role of MRI in screening women at high-risk for breast cancer
Breast magnetic resonance imaging (MRI) is a powerful diagnostic tool used for breast cancer screening. It has several advantages over other imaging techniques. In addition to being less invasive, MRI also has higher sensitivity and specificity. However, it is not recommended for follow-up in invasive breast cancer. Several studies have examined the use of MRI for breast cancer detection and the impact of MRI on clinical outcomes. The results of these studies are complex and varied. They may vary considerably between practice sites.
MRI of the breast is typically reserved for screening women at high risk for breast cancer. These women have a lifetime risk of developing a breast cancer greater than 20 to 25 percent. They are also at risk for genetic disorders, which are considered to be a high risk factor. Women at lower risk may still benefit from regular screening, especially those with dense breasts.
In addition to screening for high-risk patients, MRI may be used in post-treatment surveillance for those at high risk for recurrence. This is an important aspect of value-based healthcare. Value is defined as a patient outcome that exceeds a cost. Increasing the quality of breast imaging is a goal of health policymakers. While some studies have found positive results, a large number of studies have suggested that the sensitivity and specificity of MRI are inferior to mammography.
In an attempt to determine whether MRI is better than mammography at detecting breast cancer, Lehman and colleagues conducted a study. They analyzed the data from a large sample of women who had MRI for the purpose of breast cancer screening. Although they found a small increase in the sensitivity of MRI, they did not determine whether this increased sensitivity had an additive effect. Their conclusion was that further research was needed to determine the clinical outcome of using MRI for breast cancer screening.
A study by the American Society of Breast Surgeons concluded that the sensitivity of MRI for the detection of ipsilateral and contralateral breast cancer was 79.4 and 88.5 percent, respectively. They also found that the rate of abnormal interpretation was 8.0 percent. Approximately 5.5 and 8.1 percent of these findings led to a mastectomy or more extensive surgery, respectively.
