MRI is more accurate for detecting breast cancer than mammography, ultrasound or clinical breast examination alone, in women who carry the BRCA1 or BRCA2 gene mutation, according to a study in the September 15 issue of JAMA.
Women with BRCA1 and BRCA2 mutations who do not undergo prophylactic surgery have a lifetime risk of breast cancer of up to 85 percent, with a significantly higher risk of breast cancer than the general population from age 25 years onward, according to background information in the article. Current recommendations for women who have a BRCA1 or BRCA2 mutation are to undergo breast surveillance from age 25 years onward with mammography annually and clinical breast examination (CBE) every 6 months; however, many tumors are detected at a relatively advanced stage. Magnetic resonance imaging (MRI) and ultrasound may improve the ability to detect breast cancer at an early stage.
Ellen Warner, M.D., of Toronto-Sunnybrook Regional Cancer Centre, Toronto, Ontario, Canada, and colleagues compared the sensitivity and specificity of four methods of breast cancer surveillance (mammography, ultrasound, MRI, and CBE) in women with hereditary susceptibility to breast cancer due to a BRCA1 or BRCA2 mutation.
The study included 236 women aged 25 to 65 years with BRCA1 or BRCA2 mutations who underwent 1 to 3 annual screening examinations, consisting of MRI, mammography, and ultrasound at a teaching hospital between November 1997 and March 2003. On the day of imaging and at 6-month intervals, CBE was performed.