Application of Abbreviated Protocol of Magnetic Resonance Imaging for Breast Cancer Screening in Dense Breast Tissue.

RATIONALE AND OBJECTIVES The study aimed to evaluate the usefulness of an abbreviated protocol (AP) of magnetic resonance imaging (MRI) in comparison to a full diagnostic protocol (FDP) of MRI in the breast cancer screening with dense breast tissue. MATERIALS AND METHODS There are 478 female participants with dense breast tissue and negative mammography results, who were imaged with MRI using AP and FDP. The AP and FDP images were analyzed separately, and the sensitivity and specificity of breast cancer detection were calculated. The chi-square test and receiver operating characteristics curves were used to assess the breast cancer diagnostic capabilities of the two protocols. RESULTS Sixteen cases of breast cancer from 478 patients with dense breasts were detected using the FDP method, with pathologic confirmation of nine cases of ductal carcinoma in situ, six cases of invasive ductal carcinoma, and one case of mucinous carcinoma. Fifteen cases of breast cancer were successfully screened using the AP method. The sensitivity showed no obvious significant difference between AP and FDP (χ2 = 0.592, P = 0.623), but the specificity showed a statistically significant difference (χ2 = 4.619, P = 0.036). The receiver operating characteristics curves showed high efficacy of both methods in the detection of breast cancer in dense breast tissue (the areas under the curve were 0.931 ± 0.025 and 0.947 ± 0.024, respectively), and the ability to diagnose breast cancer was not statistically significantly different between the two methods. CONCLUSIONS The AP of MRI may improve the detection rate of breast cancer in dense breast tissue, and it may be useful in efficient breast cancer screening.

[1]  K. Koretz,et al.  Value of Ultrasound in Preoperative Local Staging in Early Breast Cancer , 2010, Ultraschall in der Medizin.

[2]  W. Berg How well does supplemental screening magnetic resonance imaging work in high-risk women? , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  Elizabeth A Morris,et al.  Rethinking breast cancer screening: ultra FAST breast magnetic resonance imaging. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  Wei Huang,et al.  A feasible high spatiotemporal resolution breast DCE-MRI protocol for clinical settings. , 2012, Magnetic resonance imaging.

[5]  Roberto Pastor-Barriuso,et al.  Mammographic density and risk of breast cancer according to tumor characteristics and mode of detection: a Spanish population-based case-control study , 2013, Breast Cancer Research.

[6]  P. Porter,et al.  Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers. , 2000, Journal of the National Cancer Institute.

[7]  C. Flowers,et al.  Cost-effectiveness of MRI compared to mammography for breast cancer screening in a high risk population , 2009, BMC health services research.

[8]  T. M. Kolb,et al.  Comparison of the performance of screening mammography, physical examination, and breast US and evaluation of factors that influence them: an analysis of 27,825 patient evaluations. , 2002, Radiology.

[9]  S. Heywang,et al.  MR imaging of the breast with Gd-DTPA: use and limitations. , 1989, Radiology.

[10]  Karla Kerlikowske,et al.  The mammogram that cried Wolfe. , 2007, The New England journal of medicine.

[11]  E. Sickles,et al.  Large rodlike calcifications at mammography: analysis of morphologic features. , 2013, AJR. American journal of roentgenology.

[12]  V. McCormack,et al.  Breast Cancer Risk : A Meta-analysis Breast Density and Parenchymal Patterns as Markers of Updated , 2006 .

[13]  Etta D Pisano,et al.  Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. , 2012, JAMA.

[14]  A. Paterson,et al.  Mammographic breast density as an intermediate phenotype for breast cancer. , 2005, The Lancet. Oncology.

[15]  Timothy J Wilt,et al.  Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. , 2009, Annals of internal medicine.

[16]  P. Narula MAMMOGRAPHIC DENSITY AND THE RISK AND DETECTION OF BREAST CANCER , 2016 .

[17]  D. Miglioretti,et al.  Individual and Combined Effects of Age, Breast Density, and Hormone Replacement Therapy Use on the Accuracy of Screening Mammography , 2003, Annals of Internal Medicine.

[18]  Timothy J Wilt,et al.  Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement. , 2009, Annals of internal medicine.

[19]  Gisella Gennaro,et al.  Digital breast tomosynthesis versus digital mammography: a clinical performance study , 2010, European Radiology.

[20]  K. Kerlikowske,et al.  Effect of age, breast density, and family history on the sensitivity of first screening mammography. , 1996, JAMA.

[21]  J. Smallwood,et al.  Diagnosis and treatment of early breast cancer, including locally advanced disease—summary of NICE guidance , 2009, BMJ : British Medical Journal.

[22]  V. Brower Homing in on mechanisms linking breast density to breast cancer risk. , 2010, Journal of the National Cancer Institute.

[23]  Ralf-Dieter Hilgers,et al.  Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI. , 2014, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[24]  Paola Clauser,et al.  Additional findings at preoperative breast MRI: the value of second-look digital breast tomosynthesis , 2015, European Radiology.

[25]  H. Sack [Increasing incidence and declining mortality in breast carcinoma]. , 1997, Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al].

[26]  Christer Ullberg,et al.  Clinical experience of photon counting breast tomosynthesis: comparison with traditional mammography , 2011, Acta radiologica.

[27]  V. McCormack,et al.  Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis , 2006, Cancer Epidemiology Biomarkers & Prevention.

[28]  E. Pisano,et al.  Imaging and cancer: research strategy of the American College of Radiology Imaging Network. , 2005, Radiology.

[29]  Jennifer A Harvey,et al.  Quantitative assessment of mammographic breast density: relationship with breast cancer risk. , 2004, Radiology.

[30]  J. Lortet-Tieulent,et al.  Breast Cancer Screening for Women at Average Risk: 2015 Guideline Update From the American Cancer Society , 2016 .

[31]  A. Jemal,et al.  Cancer Statistics, 2010 , 2010, CA: a cancer journal for clinicians.

[32]  E. Halpern,et al.  Mammographic breast density and race. , 2007, AJR. American journal of roentgenology.

[33]  H. Y. Kim,et al.  Evaluation of Malignancy Risk Stratification of Microcalcifications Detected on Mammography: A Study Based on the 5th Edition of BI-RADS , 2015, Annals of Surgical Oncology.

[34]  J. Ranstam,et al.  Increasing incidence of and declining mortality from breast carcinoma , 1997, Cancer.

[35]  S Kamen,et al.  The task force. , 1976, Journal of hospital dental practice.

[36]  Mark A Helvie,et al.  Invasive cancers detected after breast cancer screening yielded a negative result: relationship of mammographic density to tumor prognostic factors. , 2004, Radiology.