Annual MRI a Plus in Women With Past Cancer

In diagnostic performance, the recall rate – the percentage recalled for additional testing – was 9.3% (60 of 646) in the personal history group, significantly lower than the 15.0% (49 of 327) in the genetic or family history group.

The positive predictive value of biopsy – the percentage found to be malignant – in the personal history group was 35.7% (20 of 56), significantly higher than in the genetic and family history group (12.2%, or 5 of 41).

The cancer yield – the fraction of all women screened who were found to have a malignancy – was 3.1% (20 of 646) in the personal history group, or more than twice the 1.5% (5 of 327) found in the genetic and family history group (P = .14). The sensitivity was 90.9% (20 of 22) in the personal history group (which had two false negatives not found with breast MRI) vs. 100% (5 of 5) in the genetic and family history group. Specificity was 93.6% (584 of 624) in the personal history group, higher than the genetic and family history group's 86.3% (278 of 322).

The date of original cancer was available for 18 of the 20 malignancies detected by MRI, and 11 of the 18 were detected greater than 5 years after the original cancer.

“Women with a personal history of breast cancer had a lower recall rate, higher positive predictive value, higher cancer yield (although not statistically significant), and higher specificity.,” said Dr. DeMartini.

Screening breast MRI may therefore be an important adjunct to mammography in women with a personal history of breast cancer, she said.

Mammography images of the left breast (top) show no abnormality in a woman with a history of right-breast invasive cancer treated with mastectomy. MRI from the same patient shows a 15-mm mass, which biopsy revealed to be invasive cancer.

Source Courtesy Radiological Society of North America