Evaluation of breast screening strategies in a high risk breast and ovarian cancer clinic

Gynecologic Oncology Reports

Susan C. Modesitt¹  Martha E. Stewart²  Anne T. Knisely³  Martha H. Thomas⁴  Christine Garcia⁴  Kari L. Ring⁴ 

[1] Kaiser Permanente San Francisco Medical Center, United States;New York Presbyterian Hospital, United States;Columbia University College of Physicians and Surgeons, United States;University of Virginia Health System, Division of Gynecologic Oncology, United States;

关键词: BRCA;    Breast cancer;    Breast MRI;    DCIS;    Mammogram;    Breast cancer screening;   

DOI  :  

来源: DOAJ

【 摘 要 】

Recent data suggest that BRCA mutation carriers younger than 40 may not benefit from mammography in addition to MRI. Our objective was to evaluate screening modalities utilized in a high-risk population. Clinicopathologic data were abstracted for patients followed in a high risk clinic from 2007 to 2017. Descriptive statistics were calculated and associations between categorical variables were evaluated using chi-square tests. 631 women comprised the study population; 496 patients had no known mutation (79%), 128 (20%) had a BRCA mutation, and 7 patients had other deleterious mutations. BRCA mutation carriers were more likely to have cancers diagnosed after mammogram callbacks (p = 0.0046) and biopsies (p = 0.0026) compared to non-BRCA mutation carriers. BRCA mutation carriers were also more likely to have cancers diagnosed after biopsies following screening MRI (p = 0.045). 13 BRCA patients were diagnosed with cancer (average age 51). Of the cancers diagnosed after abnormal MRI, 3 were DCIS; all 3 patients had a normal mammogram 4–6 months prior. In those found after abnormal mammogram (n = 6), follow up MRI was performed in 4 cases; all demonstrated the lesion. Three patients were diagnosed younger than 40, 1 on mammogram and 2 on MRI. The patient diagnosed on mammogram had no prior MRI and the lesion was seen on follow-up MRI. Interval screening MRI identified DCIS in BRCA patients with a previous normal mammogram and cancers diagnosed on mammogram were all identified on follow-up MRI. These findings support further evaluation of MRI alone until age 40 in BRCA mutation carriers.

【 授权许可】

Unknown