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Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma.
Cancer. 2004 Feb 01; 100(3):479-89.C

Abstract

BACKGROUND

Intensive screening is an alternative to prophylactic mastectomy in women at high risk for developing breast carcinoma. The current article reports preliminary results from a screening protocol using high-quality magnetic resonance imaging (MRI), ductal lavage (DL), clinical breast examination, and mammography to identify early malignancy and high-risk lesions in women at increased genetic risk of breast carcinoma.

METHODS

Women with inherited BRCA1 or BRCA2 mutations or women with a >10% risk of developing breast carcinoma at 10 years, as estimated by the Claus model, were eligible. Patients were accrued from September 2001 to May 2003. Enrolled patients underwent biannual clinical breast examinations and annual mammography, breast MRI, and DL.

RESULTS

Forty-one women underwent an initial screen. Fifteen of 41 enrolled women (36.6%) either had undergone previous bilateral oophorectomy and/or were on tamoxifen at the time of the initial screen. One patient who was a BRCA1 carrier had high-grade ductal carcinoma in situ (DCIS) that was screen detected by MRI but that was missed on mammography. High-risk lesions that were screen detected by MRI in three women included radial scars and atypical lobular hyperplasia. DL detected seven women with cellular atypia, including one woman who had a normal MRI and mammogram.

CONCLUSIONS

Breast MRI identified high-grade DCIS and high-risk lesions that were missed by mammography. DL detected cytologic atypia in a high-risk cohort. A larger screening trial is needed to determine which subgroups of high-risk women will benefit and whether the identification of malignant and high-risk lesions at an early stage will impact breast carcinoma incidence and mortality.

Authors+Show Affiliations

Department of Medicine, Stanford University School of Medicine, Stanford, California 94305-5458, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14745863

Citation

Hartman, Anne-Renee, et al. "Breast Magnetic Resonance Image Screening and Ductal Lavage in Women at High Genetic Risk for Breast Carcinoma." Cancer, vol. 100, no. 3, 2004, pp. 479-89.
Hartman AR, Daniel BL, Kurian AW, et al. Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma. Cancer. 2004;100(3):479-89.
Hartman, A. R., Daniel, B. L., Kurian, A. W., Mills, M. A., Nowels, K. W., Dirbas, F. M., Kingham, K. E., Chun, N. M., Herfkens, R. J., Ford, J. M., & Plevritis, S. K. (2004). Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma. Cancer, 100(3), 479-89.
Hartman AR, et al. Breast Magnetic Resonance Image Screening and Ductal Lavage in Women at High Genetic Risk for Breast Carcinoma. Cancer. 2004 Feb 1;100(3):479-89. PubMed PMID: 14745863.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Breast magnetic resonance image screening and ductal lavage in women at high genetic risk for breast carcinoma. AU - Hartman,Anne-Renee, AU - Daniel,Bruce L, AU - Kurian,Allison W, AU - Mills,Meredith A, AU - Nowels,Kent W, AU - Dirbas,Frederick M, AU - Kingham,Kerry E, AU - Chun,Nicki M, AU - Herfkens,Robert J, AU - Ford,James M, AU - Plevritis,Sylvia K, PY - 2004/1/28/pubmed PY - 2004/2/20/medline PY - 2004/1/28/entrez SP - 479 EP - 89 JF - Cancer JO - Cancer VL - 100 IS - 3 N2 - BACKGROUND: Intensive screening is an alternative to prophylactic mastectomy in women at high risk for developing breast carcinoma. The current article reports preliminary results from a screening protocol using high-quality magnetic resonance imaging (MRI), ductal lavage (DL), clinical breast examination, and mammography to identify early malignancy and high-risk lesions in women at increased genetic risk of breast carcinoma. METHODS: Women with inherited BRCA1 or BRCA2 mutations or women with a >10% risk of developing breast carcinoma at 10 years, as estimated by the Claus model, were eligible. Patients were accrued from September 2001 to May 2003. Enrolled patients underwent biannual clinical breast examinations and annual mammography, breast MRI, and DL. RESULTS: Forty-one women underwent an initial screen. Fifteen of 41 enrolled women (36.6%) either had undergone previous bilateral oophorectomy and/or were on tamoxifen at the time of the initial screen. One patient who was a BRCA1 carrier had high-grade ductal carcinoma in situ (DCIS) that was screen detected by MRI but that was missed on mammography. High-risk lesions that were screen detected by MRI in three women included radial scars and atypical lobular hyperplasia. DL detected seven women with cellular atypia, including one woman who had a normal MRI and mammogram. CONCLUSIONS: Breast MRI identified high-grade DCIS and high-risk lesions that were missed by mammography. DL detected cytologic atypia in a high-risk cohort. A larger screening trial is needed to determine which subgroups of high-risk women will benefit and whether the identification of malignant and high-risk lesions at an early stage will impact breast carcinoma incidence and mortality. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/14745863/Breast_magnetic_resonance_image_screening_and_ductal_lavage_in_women_at_high_genetic_risk_for_breast_carcinoma_ L2 - https://doi.org/10.1002/cncr.11926 DB - PRIME DP - Unbound Medicine ER -