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Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study.

Publication ,  Journal Article
Lehman, CD; Isaacs, C; Schnall, MD; Pisano, ED; Ascher, SM; Weatherall, PT; Bluemke, DA; Bowen, DJ; Marcom, PK; Armstrong, DK; Domchek, SM ...
Published in: Radiology
August 2007

PURPOSE: To prospectively determine cancer yield, callback and biopsy rates, and positive predictive value (PPV) of mammography, magnetic resonance (MR) imaging, and ultrasonography (US) in women at high risk for breast cancer. MATERIALS AND METHODS: The study was approved by the institutional review board and was HIPAA compliant, and informed consent was obtained. We conducted a prospective pilot study of screening mammography, MR, and US in asymptomatic women 25 years of age or older who were genetically at high risk, defined as BRCA1/BRCA2 carriers or with at least a 20% probability of carrying a BRCA1/BRCA2 mutation. All imaging modalities were performed within 90 days of each other. Data were analyzed by using exact confidence intervals (CIs) and the McNemar test. RESULTS: A total of 195 women were enrolled in this study over a 6-month period, and 171 completed all study examinations (mammography, US, and MR). Average age of the 171 participants was 46 years +/- 10.2 (standard deviation). Sixteen biopsies were performed and six cancers were detected, for an overall 3.5% cancer yield. MR enabled detection of all six cancers; mammography, two; and US, one. The diagnostic yields for each test were 3.5% for MR, 0.6% for US, and 1.2% for mammography. MR, US, and mammography findings prompted biopsy in 8.2%, 2.3%, and 2.3% of patients, respectively. None of the pairwise comparisons were statistically significant. The PPV of biopsies performed as a result of MR was 43%. CONCLUSION: Screening MR imaging had a higher biopsy rate but helped detect more cancers than either mammography or US. US had the highest false-negative rate compared with mammography and MR, enabling detection of only one in six cancers in high-risk women.

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Published In

Radiology

DOI

ISSN

0033-8419

Publication Date

August 2007

Volume

244

Issue

2

Start / End Page

381 / 388

Location

United States

Related Subject Headings

  • United States
  • Ultrasonography, Mammary
  • Risk Factors
  • Prospective Studies
  • Predictive Value of Tests
  • Population Surveillance
  • Pilot Projects
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Mammography
 

Citation

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Lehman, C. D., Isaacs, C., Schnall, M. D., Pisano, E. D., Ascher, S. M., Weatherall, P. T., … Gatsonis, C. (2007). Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study. Radiology, 244(2), 381–388. https://doi.org/10.1148/radiol.2442060461
Lehman, Constance D., Claudine Isaacs, Mitchell D. Schnall, Etta D. Pisano, Susan M. Ascher, Paul T. Weatherall, David A. Bluemke, et al. “Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study.Radiology 244, no. 2 (August 2007): 381–88. https://doi.org/10.1148/radiol.2442060461.
Lehman CD, Isaacs C, Schnall MD, Pisano ED, Ascher SM, Weatherall PT, et al. Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study. Radiology. 2007 Aug;244(2):381–8.
Lehman, Constance D., et al. “Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study.Radiology, vol. 244, no. 2, Aug. 2007, pp. 381–88. Pubmed, doi:10.1148/radiol.2442060461.
Lehman CD, Isaacs C, Schnall MD, Pisano ED, Ascher SM, Weatherall PT, Bluemke DA, Bowen DJ, Marcom PK, Armstrong DK, Domchek SM, Tomlinson G, Skates SJ, Gatsonis C. Cancer yield of mammography, MR, and US in high-risk women: prospective multi-institution breast cancer screening study. Radiology. 2007 Aug;244(2):381–388.
Journal cover image

Published In

Radiology

DOI

ISSN

0033-8419

Publication Date

August 2007

Volume

244

Issue

2

Start / End Page

381 / 388

Location

United States

Related Subject Headings

  • United States
  • Ultrasonography, Mammary
  • Risk Factors
  • Prospective Studies
  • Predictive Value of Tests
  • Population Surveillance
  • Pilot Projects
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Mammography