Surveillance Breast MRI Ups Biopsy, Cancer Detection Rates

Use of surveillance breast magnetic resonance imaging (MRI) is associated with increased biopsy and subsequent cancer detection rates compared with mammography alone among women with a personal history of breast cancer, according to a study published in Radiology.

Karen J. Wernli, Ph.D., from the Kaiser Permanente Washington Health Research Institute in Seattle, and colleagues compared performance of surveillance mammography to performance of breast MRI in an observational cohort study. Data were included for 13,266 women with stage 0 to III breast cancer who underwent 33,938 mammographic examinations and 2,506 breast MRI examinations from 2005 to 2012. Women were classified as mammography alone (11,745 women) or breast MRI (1,521 women).

The researchers found that for breast MRI versus mammography, raw performance measures were: cancer detection rates, 10.8 versus 8.2 per 1,000 examinations; sensitivity, 61.4 versus 70.3 percent; and biopsy rate, 10.1 versus 4.0 percent. Breast MRI was associated with a higher biopsy rate and cancer detection rate than mammography alone in multivariable models (odds ratios, 2.2 and 1.7, respectively). No differences were seen in sensitivity or interval cancer rate.

"For women with a personal history of breast cancer, the potential benefits and harms, specifically the effect of increased biopsies, should be carefully considered when incorporating breast MRI into surveillance imaging strategies," the authors write.

Several authors disclosed financial ties to the medical technology industry.

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