Skip to main content
×
Home
    • Aa
    • Aa

MRI in familial breast cancer

  • K. G. A. Gilhuijs (a1) and E. E. Deurloo (a1) (a2)
Abstract

Five to ten per cent of all breast cancers are associated with a proven genetic predisposition for the disease or a strong family history of breast cancer in which yet unknown genetic predisposition is suspected. Carriers of germline mutations in genes breast cancer 1 or 2 (BRCA1/2) have up to 85% chance of developing breast cancer during their lifetime. The majority of these women develop the disease before the age of 50 years. Consequently, breast-cancer screening programmes aimed at reducing mortality in this population may only be effective if they start at much younger age than the general breast-cancer screening programmes. Unfortunately, the efficacy of conventional X-ray mammography in premenopausal women is often limited by dense fibroglandular tissue that obscures suspicious lesions. As a result, more advanced breast-imaging techniques have been considered, such as contrast-enhanced (CE) magnetic resonance imaging (MRI). In symptomatic patients, the sensitivity of CE MRI to detect invasive breast cancer is known to be high, regardless of the density of the fibroglandular tissue. Conversely, the specificity of CE MRI to discriminate between benign and malignant lesions is variable, and depends on the indication of the examination. Low specificity could result in many recalls on benign lesions, thus negatively affecting the cost–benefit ratio of CE MRI as a screening technique. Several single- and multi-institutional studies have been performed to investigate the efficacy of CE MRI as a screening tool exclusively for asymptomatic women at increased lifetime risk of breast cancer. Mounting evidence suggests that the addition of CE MRI results in cost-effective detection of tumours at earlier stage in BRCA1/2 mutation carriers. The value of CE MRI in other populations at risk is currently uncertain, and it is unlikely that CE MRI will be cost efficient in the general screening population of women who are not at increased lifetime risk.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      MRI in familial breast cancer
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      MRI in familial breast cancer
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      MRI in familial breast cancer
      Available formats
      ×
Copyright
Corresponding author
Correspondence to: K. G. A. Gilhuijs, Department of Radiology, The Netherlands Cancer Institute/Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands. Tel: +31-20-512-2941; Fax: +31-20-512-2934
References
Hide All

References

Research Committee of the Netherlands Cancer Registry. Incidence of cancer in the Netherlands 1999/2000. 2003; 1.0.
Easton DF, Bishop DT, Ford D, Crockford GP. Genetic linkage analysis in familial breast and ovarian cancer: results from 214 families. The Breast Cancer Linkage Consortium. Am J Hum Genet 1993; 52: 678701.
Miki Y, Swensen J, Shattuck-Eidens D, et al. A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science 1994; 266: 6671.
Wooster R, Bignell G, Lancaster J, et al. Identification of the breast cancer susceptibility gene BRCA2. Nature 1995; 378: 789792.
Lynch HT, Albano WA, Danes BS, et al. Genetic predisposition to breast cancer. Cancer 1984; 53: 612622.
Struewing JP, Hartge P, Wacholder S, et al. The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews. New Engl J Med 1997; 336: 14011408.
Easton DF, Ford D, Bishop DT. Breast and ovarian cancer incidence in BRCA1-mutation carriers. Breast Cancer Linkage Consortium. Am J Hum Genet 1995; 56: 265271.
Claus EB, Schildkraut JM, Thompson WD, Risch NJ. The genetic attributable risk of breast and ovarian cancer. Cancer 1996; 77: 23182324.
Johannsson OT, Idvall I, Anderson C, et al. Tumour biological features of BRCA1-induced breast and ovarian cancer. Eur J Cancer 1997; 33: 362371.
Kaas R, Kroger R, Hendriks JH, et al. The significance of circumscribed malignant mammographic masses in the surveillance of BRCA 1/2 gene mutation carriers. Eur Radiol 2004; 14: 16471653.
Hartmann LC, Schaid DJ, Woods JE, et al. Efficacy of bilateral prophylactic mastectomy in women with a family history of breast cancer. New Engl J Med 1999; 340: 7784.
Grann VR, Jacobson JS, Whang W, et al. Prevention with tamoxifen or other hormones versus prophylactic surgery in BRCA1/2-positive women: a decision analysis. Cancer J Sci Am 2000; 6: 1320.
Evans D, Lalloo F, Shenton A, Boggis C, Howell A. Uptake of screening and prevention in women at very high risk of breast cancer. Lancet 2001; 358: 889890.
Vasen HF, Haites NE, Evans DG, et al. Current policies for surveillance and management in women at risk of breast and ovarian cancer: a survey among 16 European family cancer clinics. European Familial Breast Cancer Collaborative Group. Eur J Cancer 1998; 34: 19221926.
Nystrom L, Andersson I, Bjurstam N, Frisell J, Nordenskjold B, Rutqvist LE. Long-term effects of mammography screening: updated overview of the Swedish randomised trials. Lancet 2002; 359: 909919.
Stomper PC, D'Souza DJ, DiNitto PA, Arredondo MA. Analysis of parenchymal density on mammograms in 1353 women 25–79 years old. Am J Roentgenol 1996; 167: 12611265.
Lehman CD, White E, Peacock S, Drucker MJ, Urban N. Effect of age and breast density on screening mammograms with false-positive findings. Am J Roentgenol 1999; 173: 16511655.
Zonderland HM, Coerkamp EG, Hermans J, van de Vijver MJ, van Voorthuisen AE. Diagnosis of breast cancer: contribution of US as an adjunct to mammography. Radiology 1999; 213: 413422.
Shaw de Paredes E, Marsteller LP, Eden BV. Breast cancers in women 35 years of age and younger: mammographic findings. Radiology 1990; 177: 117119.
Morrow M. Identification and management of the woman at increased risk for breast cancer development. Breast Cancer Res Treat 1994; 31: 5360.
Peer PG, Verbeek AL, Straatman H, Hendriks JH, Holland R. Age-specific sensitivities of mammographic screening for breast cancer. Breast Cancer Res Treat 1996; 38: 153160.
Tilanus-Linthorst MM, Obdeijn IM, Bartels KC, de Koning HJ, Oudkerk M. First experiences in screening women at high risk for breast cancer with MR imaging. Breast Cancer Res Treat 2000; 63: 5360.
Kuhl CK, Schmutzler RK, Leutner CC, et al. Breast MR imaging screening in 192 women proved or suspected to be carriers of a breast cancer susceptibility gene: preliminary results. Radiology 2000; 215: 267279.
Tilanus-Linthorst M, Verhoog L, Obdeijn IM, et al. A BRCA1/2 mutation, high breast density and prominent pushing margins of a tumor independently contribute to a frequent false-negative mammography. Int J Cancer 2002; 102: 9195.
Feig SA. Assessment of radiation risk from screening mammography. Cancer 1996; 77: 818822.
Orel SG, Mendonca MH, Reynolds C, Schnall MD, Solin LJ, Sullivan DC. MR imaging of ductal carcinoma in situ. Radiology 1997; 202: 413420.
Viehweg P, Paprosch I, Strassinopoulou M, Heywang-Kobrunner SH. Contrast-enhanced magnetic resonance imaging of the breast: interpretation guidelines. Top Magn Reson Imag 1998; 9: 1743.
Warner E, Plewes DB, Hill KA, et al. Surveillance of BRCA1 and BRCA2 mutation carriers with magnetic resonance imaging, ultrasound, mammography, and clinical breast examination. J Am Med Assoc 2004; 292: 13171325.
Podo F, Sardanelli F, Canese R, et al. The Italian multi-centre project on evaluation of MRI and other imaging modalities in early detection of breast cancer in subjects at high genetic risk. J Exp Clin Cancer Res 2002; 21: 115124.
Heywang SH, Hahn D, Schmidt H, et al. MR imaging of the breast using gadolinium-DTPA. J Comput Assist Tomogr 1986; 10: 199204.
Brasch RC, Weinmann HJ, Wesbey GE. Contrast-enhanced NMR imaging: animal studies using gadolinium-DTPA complex. Am J Roentgenol 1984; 142: 625630.
Strich G, Hagan PL, Gerber KH, Slutsky RA. Tissue distribution and magnetic resonance spin lattice relaxation effects of gadolinium-DTPA. Radiology 1985; 154: 723726.
Kelcz F, Santyr G. Gadolinium-enhanced breast MRI. Crit Rev Diagn Imag 1995; 36: 287338.
Obdeijn IM, Kuijpers TJ, van Dijk P, Wiggers T, Oudkerk M. MR lesion detection in a breast cancer population. J Magn Reson Imag 1996; 6: 849854.
Bone B, Pentek Z, Perbeck L, Veress B. Diagnostic accuracy of mammography and contrast-enhanced MR imaging in 238 histologically verified breast lesions. Acta Radiol 1997; 38: 489496.
Heywang-Kobrunner SH, Viehweg P, Heinig A, Kuchler C. Contrast-enhanced MRI of the breast: accuracy, value, controversies, solutions. Eur J Radiol 1997; 24: 94108.
Tilanus-Linthorst MM, Obdeijn AI, Bontenbal M, Oudkerk M. MRI in patients with axillary metastases of occult breast carcinoma. Breast Cancer Res Treat 1997; 44: 179182.
Morris EA, Schwartz LH, Dershaw DD, et al. MR imaging of the breast in patients with occult primary breast carcinoma. Radiology 1997; 205: 437440.
Gilles R, Zafrani B, Guinebretiere JM, et al. Ductal carcinoma in situ: MR imaging–histopathologic correlation. Radiology 1995; 196: 415419.
Westerhof JP, Fischer U, Moritz JD, Oestmann JW. MR imaging of mammographically detected clustered microcalcifications: is there any value? Radiology 1998; 207: 675681.
American College of Radiology (ACR) Breast Imaging Reporting and Data System Atlas (BI-RADS® Atlas), 2003.
Brett J, Austoker J, Ong G. Do women who undergo further investigation for breast screening suffer adverse psychological consequences? A multi-centre follow-up study comparing different breast screening result groups five months after their last breast screening appointment. J Public Health Med 1998; 20: 396403.
Gilhuijs KG, Deurloo EE, Muller SH, Peterse JL, Schultze Kool LJ. Breast MR imaging in women at increased lifetime risk of breast cancer: clinical system for computerized assessment of breast lesions initial results. Radiology 2002; 225: 907916.
Deurloo EE, Muller SH, Peterse JL, Besnard APE, Gilhuijs KGA. Clinically and mammographically occult breast lesions at MR imaging: potential impact of computerized assessment on clinical reading. Radiology 2005 (in press).
Kriege M, Brekelmans CT, Boetes C, et al. Efficacy of MRI and mammography for breast-cancer screening in women with a familial or genetic predisposition. New Engl J Med 2004; 351: 427437.
Liberman L. Breast cancer screening with MRI – what are the data for patients at high risk? New Engl J Med 2004; 351: 497500.
Robson ME, Offit K. Breast MRI for women with hereditary cancer risk. J Am Med Assoc 2004; 292: 13681370.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Breast Cancer Online
  • ISSN: -
  • EISSN: 1470-9031
  • URL: /core/journals/breast-cancer-online
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Full text views

Total number of HTML views: 1
Total number of PDF views: 16 *
Loading metrics...

Abstract views

Total abstract views: 48 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th October 2017. This data will be updated every 24 hours.