MRI as a Screening Tool in High Risk Women
| Study | Type of Study | Study Population | N | Mean Age/Range | Major Findings/Comments |
|---|---|---|---|---|---|
| Leach et al.55 | Prospective | Women at high risk for breast cancer (BRCA 1, 2, or TP53 mutation, 1st degree relative with mutation, family history of breast/ovarian CA, family history of Li-Fraumeni syndrome) | 649 | 31 to 55 | Sensitivity for CE MRI and XRM was 77% and 40%, respectively; specificity for CE MRI and XRM was 81% and 93%, respectively; sensitivity and specificity for both methods combined was 94% and 77%, respectively; sensitivity of CE MRI for BRCA 1 and BRCA 2 were 92% and 58%, respectively |
| Lehman et al.56 | Prospective | Women ≥25 with high familial or genetic risk of breast cancer | 367 | 40 | 1.1% of patients screened with MRI had breast cancer by pathology as opposed to 0.3% by XRM (difference not statistically significant); PPV of biopsies performed as a result of MRI was 17% (4/24); PPV of biopsies performed as a result of XRM was 25% (1/4) |
| Sim et al.58 | Retrospective | Women who were at least at 15% greater risk for breast cancer (Claus model) | 179 | Sensitivity for MRI, XRM, and US were 93.3%, 83.3%, and 53.9%, respectively; specificity for MRI, XRM, and US were 63.6%, 65.5%, and 85.7%, respectively; the sensitivity and specificity for combined XRM and US was 92.9% and 62.5%, respectively | |
| Kriege et al.50 | Prospective | Women who were at least at 15% greater risk for breast cancer due to familial or genetic factors (Claus model) | 1909 | 40 | Sensitivity for MRI in detecting invasive breast cancer as opposed to CBE and XRM was 79.5%, 17.9%, and 33.3%, respectively; specificity for MRI, CBE, and XRM was 89.8%, 98.1%, and 95.0%, respectively |
| Morris et al.54 | Retrospective | Women at high risk for breast cancer (past history, family history, LCIS, atypia) with negative XRM | 367 | 50 | 4% of screened patients had breast cancer by pathology (57% were DCIS); percentage was higher in those women with past and family history (8%), PPV 50%; PPV of biopsy was 24% |
| Warner et al.49 | Prospective | Women who were carriers of BRCA 1 and/or BRCA 2 | 236 | 25 to 65 | Sensitivity for MRI as opposed to XRM, US, and CBE were 77%, 36% (P = .02), 33% (P = .006), and 9.1%, respectively; specificity for MRI, XRM, US, and CBE were 95.4%, 99.8%, 96%, and 99.3%, respectively; when all modalities were combined there was a sensitivity of 95% as opposed to 45% with XRM and CBE combined |
| Podo et al.57 | Prospective | Women with confirmed BRCA 1 or BRCA 2 mutations or with a 1 in 2 chance of having the mutation | 105 | 55.3 | 8 breast cancers were identified (all by CE MRI); only 1 was detected by XRM and US; total incidence of breast cancer was 7.6% |