Screening Breast MRI in Patients Previously Treated for Breast Cancer: Diagnostic Yield for Cancer and Abnormal Interpretation Rate

Catherine S. Giess, Patricia S. Poole, Sona A. Chikarmane, Dorothy A. Sippo, Robyn L. Birdwell

Research output: Contribution to journalArticle

Abstract

Rationale and Objectives: To determine the cancer detection rate and abnormal interpretation rate of screening breast magnetic resonance imaging (MRI) in previously treated breast cancer patients. Materials and Methods: Institutional review board-approved retrospective review of the breast MRI database from 2009 to 2011 identified a total of 3297 screening examinations. After excluding genetic mutation carriers, untested first-degree relatives of known mutation carriers, and patients with a history of chest irradiation, there were 1194 (36.2%) examinations in 691 patients previously treated for breast cancer. MRI reports were reviewed to determine MRI findings and breast imaging reporting and data system (BI-RADS) assessments. The longitudinal medical record was reviewed to determine patient demographics and outcomes of imaging surveillance and biopsy. Results: Mean patient age at initial cancer diagnosis was 46.1 years, and mean patient age during the study interval was 52 years. Cancer detection rate was 10 per 1000 (1%; 95% confidence interval [CI], 0.5%-1.8%]; 12 of 1194 examinations). Overall 10.7% (128 of 1194) of examinations received an abnormal interpretation, including 5.4% (65 of 1194) BI-RADS 4 or 5 and 5.3% (63 of 1194) BI-RADS 3 assessments with a 9.4% positive predictive value (PPV1; 12 of 128 examinations) and a 17.9% PPV3 (12 malignancies per 67 biopsies). Conclusions: Screening breast MRI in women previously treated for breast cancer detected cancer in 1.0% of examinations, with a 10.7% abnormal interpretation rate, and a PPV for malignancy of 17.9%.

Original languageEnglish (US)
Pages (from-to)1331-1337
Number of pages7
JournalAcademic Radiology
Volume22
Issue number11
DOIs
StatePublished - Nov 1 2015
Externally publishedYes

Fingerprint

Breast
Magnetic Resonance Imaging
Breast Neoplasms
Information Systems
Neoplasms
Biopsy
Mutation
Research Ethics Committees
Heterozygote
Medical Records
Thorax
Demography
Databases
Confidence Intervals

Keywords

  • Breast
  • Breast cancer
  • Breast MRI
  • Screening

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Screening Breast MRI in Patients Previously Treated for Breast Cancer : Diagnostic Yield for Cancer and Abnormal Interpretation Rate. / Giess, Catherine S.; Poole, Patricia S.; Chikarmane, Sona A.; Sippo, Dorothy A.; Birdwell, Robyn L.

In: Academic Radiology, Vol. 22, No. 11, 01.11.2015, p. 1331-1337.

Research output: Contribution to journalArticle

Giess, Catherine S. ; Poole, Patricia S. ; Chikarmane, Sona A. ; Sippo, Dorothy A. ; Birdwell, Robyn L. / Screening Breast MRI in Patients Previously Treated for Breast Cancer : Diagnostic Yield for Cancer and Abnormal Interpretation Rate. In: Academic Radiology. 2015 ; Vol. 22, No. 11. pp. 1331-1337.
@article{ad8f4fac962b493d9ea278da655b33de,
title = "Screening Breast MRI in Patients Previously Treated for Breast Cancer: Diagnostic Yield for Cancer and Abnormal Interpretation Rate",
abstract = "Rationale and Objectives: To determine the cancer detection rate and abnormal interpretation rate of screening breast magnetic resonance imaging (MRI) in previously treated breast cancer patients. Materials and Methods: Institutional review board-approved retrospective review of the breast MRI database from 2009 to 2011 identified a total of 3297 screening examinations. After excluding genetic mutation carriers, untested first-degree relatives of known mutation carriers, and patients with a history of chest irradiation, there were 1194 (36.2{\%}) examinations in 691 patients previously treated for breast cancer. MRI reports were reviewed to determine MRI findings and breast imaging reporting and data system (BI-RADS) assessments. The longitudinal medical record was reviewed to determine patient demographics and outcomes of imaging surveillance and biopsy. Results: Mean patient age at initial cancer diagnosis was 46.1 years, and mean patient age during the study interval was 52 years. Cancer detection rate was 10 per 1000 (1{\%}; 95{\%} confidence interval [CI], 0.5{\%}-1.8{\%}]; 12 of 1194 examinations). Overall 10.7{\%} (128 of 1194) of examinations received an abnormal interpretation, including 5.4{\%} (65 of 1194) BI-RADS 4 or 5 and 5.3{\%} (63 of 1194) BI-RADS 3 assessments with a 9.4{\%} positive predictive value (PPV1; 12 of 128 examinations) and a 17.9{\%} PPV3 (12 malignancies per 67 biopsies). Conclusions: Screening breast MRI in women previously treated for breast cancer detected cancer in 1.0{\%} of examinations, with a 10.7{\%} abnormal interpretation rate, and a PPV for malignancy of 17.9{\%}.",
keywords = "Breast, Breast cancer, Breast MRI, Screening",
author = "Giess, {Catherine S.} and Poole, {Patricia S.} and Chikarmane, {Sona A.} and Sippo, {Dorothy A.} and Birdwell, {Robyn L.}",
year = "2015",
month = "11",
day = "1",
doi = "10.1016/j.acra.2015.05.009",
language = "English (US)",
volume = "22",
pages = "1331--1337",
journal = "Academic Radiology",
issn = "1076-6332",
publisher = "Elsevier USA",
number = "11",

}

TY - JOUR

T1 - Screening Breast MRI in Patients Previously Treated for Breast Cancer

T2 - Diagnostic Yield for Cancer and Abnormal Interpretation Rate

AU - Giess, Catherine S.

AU - Poole, Patricia S.

AU - Chikarmane, Sona A.

AU - Sippo, Dorothy A.

AU - Birdwell, Robyn L.

PY - 2015/11/1

Y1 - 2015/11/1

N2 - Rationale and Objectives: To determine the cancer detection rate and abnormal interpretation rate of screening breast magnetic resonance imaging (MRI) in previously treated breast cancer patients. Materials and Methods: Institutional review board-approved retrospective review of the breast MRI database from 2009 to 2011 identified a total of 3297 screening examinations. After excluding genetic mutation carriers, untested first-degree relatives of known mutation carriers, and patients with a history of chest irradiation, there were 1194 (36.2%) examinations in 691 patients previously treated for breast cancer. MRI reports were reviewed to determine MRI findings and breast imaging reporting and data system (BI-RADS) assessments. The longitudinal medical record was reviewed to determine patient demographics and outcomes of imaging surveillance and biopsy. Results: Mean patient age at initial cancer diagnosis was 46.1 years, and mean patient age during the study interval was 52 years. Cancer detection rate was 10 per 1000 (1%; 95% confidence interval [CI], 0.5%-1.8%]; 12 of 1194 examinations). Overall 10.7% (128 of 1194) of examinations received an abnormal interpretation, including 5.4% (65 of 1194) BI-RADS 4 or 5 and 5.3% (63 of 1194) BI-RADS 3 assessments with a 9.4% positive predictive value (PPV1; 12 of 128 examinations) and a 17.9% PPV3 (12 malignancies per 67 biopsies). Conclusions: Screening breast MRI in women previously treated for breast cancer detected cancer in 1.0% of examinations, with a 10.7% abnormal interpretation rate, and a PPV for malignancy of 17.9%.

AB - Rationale and Objectives: To determine the cancer detection rate and abnormal interpretation rate of screening breast magnetic resonance imaging (MRI) in previously treated breast cancer patients. Materials and Methods: Institutional review board-approved retrospective review of the breast MRI database from 2009 to 2011 identified a total of 3297 screening examinations. After excluding genetic mutation carriers, untested first-degree relatives of known mutation carriers, and patients with a history of chest irradiation, there were 1194 (36.2%) examinations in 691 patients previously treated for breast cancer. MRI reports were reviewed to determine MRI findings and breast imaging reporting and data system (BI-RADS) assessments. The longitudinal medical record was reviewed to determine patient demographics and outcomes of imaging surveillance and biopsy. Results: Mean patient age at initial cancer diagnosis was 46.1 years, and mean patient age during the study interval was 52 years. Cancer detection rate was 10 per 1000 (1%; 95% confidence interval [CI], 0.5%-1.8%]; 12 of 1194 examinations). Overall 10.7% (128 of 1194) of examinations received an abnormal interpretation, including 5.4% (65 of 1194) BI-RADS 4 or 5 and 5.3% (63 of 1194) BI-RADS 3 assessments with a 9.4% positive predictive value (PPV1; 12 of 128 examinations) and a 17.9% PPV3 (12 malignancies per 67 biopsies). Conclusions: Screening breast MRI in women previously treated for breast cancer detected cancer in 1.0% of examinations, with a 10.7% abnormal interpretation rate, and a PPV for malignancy of 17.9%.

KW - Breast

KW - Breast cancer

KW - Breast MRI

KW - Screening

UR - http://www.scopus.com/inward/record.url?scp=84944157199&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84944157199&partnerID=8YFLogxK

U2 - 10.1016/j.acra.2015.05.009

DO - 10.1016/j.acra.2015.05.009

M3 - Article

C2 - 26142951

AN - SCOPUS:84944157199

VL - 22

SP - 1331

EP - 1337

JO - Academic Radiology

JF - Academic Radiology

SN - 1076-6332

IS - 11

ER -