MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer
Constance D. Lehman, M.D., Ph.D., Constantine Gatsonis, Ph.D., Christiane K. Kuhl, M.D., R. Edward Hendrick, Ph.D., Etta D. Pisano, M.D., Lucy Hanna, M.S., Sue Peacock, M.S., Stanley F. Smazal, M.D., Daniel D. Maki, M.D., Thomas B. Julian, M.D., Elizabeth R. DePeri, M.D., David A. Bluemke, M.D., Ph.D., Mitchell D. Schnall, M.D., Ph.D., for the ACRIN Trial 6667 Investigators Group
Background Even after careful clinical and mammographic evaluation,cancer is found in the contralateral breast in up to 10% ofwomen who have received treatment for unilateral breast cancer.We conducted a study to determine whether magnetic resonanceimaging (MRI) could improve on clinical breast examination andmammography in detecting contralateral breast cancer soon afterthe initial diagnosis of unilateral breast cancer.
Methods A total of 969 women with a recent diagnosis of unilateralbreast cancer and no abnormalities on mammographic and clinicalexamination of the contralateral breast underwent breast MRI.The diagnosis of MRI-detected cancer was confirmed by meansof biopsy within 12 months after study entry. The absence ofbreast cancer was determined by means of biopsy, the absenceof positive findings on repeat imaging and clinical examination,or both at 1 year of follow-up.
Results MRI detected clinically and mammographically occultbreast cancer in the contralateral breast in 30 of 969 womenwho were enrolled in the study (3.1%). The sensitivity of MRIin the contralateral breast was 91%, and the specificity was88%. The negative predictive value of MRI was 99%. A biopsywas performed on the basis of a positive MRI finding in 121of the 969 women (12.5%), 30 of whom had specimens that werepositive for cancer (24.8%); 18 of the 30 specimens were positivefor invasive cancer. The mean diameter of the invasive tumorsdetected was 10.9 mm. The additional number of cancers detectedwas not influenced by breast density, menopausal status, orthe histologic features of the primary tumor.
Conclusions MRI can detect cancer in the contralateral breastthat is missed by mammography and clinical examination at thetime of the initial breast-cancer diagnosis. (ClinicalTrials.govnumber, NCT00058058
[ClinicalTrials.gov]
.)
Source Information
From the University of Washington Medical Center, Seattle (C.D.L., S.P.); Brown University, Providence, RI (C.G., L.H.); University of Bonn, Bonn, Germany (C.K.K.); Feinberg School of Medicine, Northwestern University, Chicago (R.E.H.); University of North Carolina, Chapel Hill (E.D.P.); Porter Adventist Hospital, Denver (S.F.S.); Scottsdale Medical Imaging, Scottsdale, AZ (D.D.M.); Allegheny General Hospital, Allegheny, PA (T.B.J.); Mayo Clinic, Jacksonville, FL (E.R.D.); Johns Hopkins University School of Medicine, Bethesda, MD (D.A.B.); and University of Pennsylvania Medical School, Philadelphia (M.D.S.).
Address reprint requests to Dr. Lehman at the University of Washington Medical Center, Seattle Cancer Care Alliance, 825 Eastlake Ave., E, Rm. G3-200, P.O. Box 19023, Seattle, WA 98109, or at lehman{at}u.washington.edu.
MRI Evaluation of Breast Cancer
Garrido-Laguna I., Fernandez Hidalgo O., Garcia Foncillas J., Gyorki D., Mann B., Frauscher F., Sweeney K. J., Sacchini V., Nash I., Marcus P. M., Fennigkoh L., Lehman C. D., Gatsonis C., Schnall M. D.
Extract |
Full Text |
PDF
N Engl J Med 2007;
357:191-193, Jul 12, 2007.
Correspondence
This article has been cited by other articles:
Virnig, B. A., Tuttle, T. M., Shamliyan, T., Kane, R. L.
(2010). Ductal Carcinoma In Situ of the Breast: A Systematic Review of Incidence, Treatment, and Outcomes. JNCI J Natl Cancer Inst
102: 170-178
[Abstract][Full Text]
Pandharipande, P. V., Gazelle, G. S.
(2009). Comparative Effectiveness Research: What It Means for Radiology. Radiology
253: 600-605
[Full Text]
Partridge, S. C., DeMartini, W. B., Kurland, B. F., Eby, P. R., White, S. W., Lehman, C. D.
(2009). Quantitative Diffusion-Weighted Imaging as an Adjunct to Conventional Breast MRI for Improved Positive Predictive Value. Am. J. Roentgenol.
193: 1716-1722
[Abstract][Full Text]
Brennan, M. E., Houssami, N., Lord, S., Macaskill, P., Irwig, L., Dixon, J. M., Warren, R. M.L., Ciatto, S.
(2009). Magnetic Resonance Imaging Screening of the Contralateral Breast in Women With Newly Diagnosed Breast Cancer: Systematic Review and Meta-Analysis of Incremental Cancer Detection and Impact on Surgical Management. JCO
27: 5640-5649
[Abstract][Full Text]
Destounis, S., Arieno, A., Somerville, P. A., Seifert, P. J., Murphy, P., Morgan, R., Skolny, M., Hanson, S., Young, W.
(2009). Community-Based Practice Experience of Unsuspected Breast Magnetic Resonance Imaging Abnormalities Evaluated With Second-Look Sonography. J Ultrasound Med
28: 1337-1346
[Abstract][Full Text]
Gutierrez, R. L., DeMartini, W. B., Eby, P. R., Kurland, B. F., Peacock, S., Lehman, C. D.
(2009). BI-RADS Lesion Characteristics Predict Likelihood of Malignancy in Breast MRI for Masses But Not for Nonmasslike Enhancement. Am. J. Roentgenol.
193: 994-1000
[Abstract][Full Text]
BALDWIN, P.
(2009). Digital Breast Tomosynthesis. radtech
81: 57M-74M
[Abstract][Full Text]
Katipamula, R., Degnim, A. C., Hoskin, T., Boughey, J. C., Loprinzi, C., Grant, C. S., Brandt, K. R., Pruthi, S., Chute, C. G., Olson, J. E., Couch, F. J., Ingle, J. N., Goetz, M. P.
(2009). Trends in Mastectomy Rates at the Mayo Clinic Rochester: Effect of Surgical Year and Preoperative Magnetic Resonance Imaging. JCO
27: 4082-4088
[Abstract][Full Text]
Morrow, M., Harris, J. R.
(2009). More Mastectomies: Is This What Patients Really Want?. JCO
27: 4038-4040
[Full Text]
Wang, L. C., DeMartini, W. B., Partridge, S. C., Peacock, S., Lehman, C. D.
(2009). MRI-Detected Suspicious Breast Lesions: Predictive Values of Kinetic Features Measured by Computer-Aided Evaluation. Am. J. Roentgenol.
193: 826-831
[Abstract][Full Text]
Houssami, N., Hayes, D. F.
(2009). Review of Preoperative Magnetic Resonance Imaging (MRI) in Breast Cancer: Should MRI Be Performed on All Women with Newly Diagnosed, Early Stage Breast Cancer?. CA Cancer J Clin
59: 290-302
[Abstract][Full Text]
Kurian, A. W., McClure, L. A., John, E. M., Horn-Ross, P. L., Ford, J. M., Clarke, C. A.
(2009). Second Primary Breast Cancer Occurrence According to Hormone Receptor Status. JNCI J Natl Cancer Inst
101: 1058-1065
[Abstract][Full Text]
Miksad, R. A., Gonen, M., Lynch, T. J., Roberts, T. G. Jr
(2009). Interpreting Trial Results in Light of Conflicting Evidence: A Bayesian Analysis of Adjuvant Chemotherapy for Non-Small-Cell Lung Cancer. JCO
27: 2245-2252
[Abstract][Full Text]
Oostendorp, M., Post, M. J., Backes, W. H.
(2009). Vessel Growth and Function: Depiction with Contrast-enhanced MR Imaging. Radiology
251: 317-335
[Abstract][Full Text]
Schell, A. M., Rosenkranz, K., Lewis, P. J.
(2009). Role of Breast MRI in the Preoperative Evaluation of Patients with Newly Diagnosed Breast Cancer. Am. J. Roentgenol.
192: 1438-1444
[Abstract][Full Text]
Elsamaloty, H., Elzawawi, M. S., Mohammad, S., Herial, N.
(2009). Increasing Accuracy of Detection of Breast Cancer with 3-T MRI. Am. J. Roentgenol.
192: 1142-1148
[Abstract][Full Text]
Zakaria, S., Brandt, K. R., Degnim, A. C., Thomsen, K. M.
(2009). Patients' Perceptions of Breast MRI: A Single-Center Study. Am. J. Roentgenol.
192: 1149-1154
[Abstract][Full Text]
Moy, L., Mercado, C. L.
(2008). Interpretation and Clinical Applications of Breast MRI: Self-Assessment Module. Am. J. Roentgenol.
191: S60-S67
[Abstract][Full Text]
Huang, W., Li, X., Morris, E. A., Tudorica, L. A., Seshan, V. E., Rooney, W. D., Tagge, I., Wang, Y., Xu, J., Springer, C. S.
(2008). The magnetic resonance shutter speed discriminates vascular properties of malignant and benign breast tumors in vivo. Proc. Natl. Acad. Sci. USA
105: 17943-17948
[Abstract][Full Text]
Imbriaco, M., Caprio, M. G., Limite, G., Pace, L., De Falco, T., Capuano, E., Salvatore, M.
(2008). Dual-Time-Point 18F-FDG PET/CT Versus Dynamic Breast MRI of Suspicious Breast Lesions. Am. J. Roentgenol.
191: 1323-1330
[Abstract][Full Text]
Daly, C. P., Jaeger, B., Sill, D. S.
(2008). Variable Appearances of Fat Necrosis on Breast MRI. Am. J. Roentgenol.
191: 1374-1380
[Abstract][Full Text]
Hartman, M., Hall, P., Edgren, G., Reilly, M., Lindstrom, L., Lichtenstein, P., Kaprio, J., Skytthe, A., Peto, J., Czene, K.
(2008). Breast Cancer Onset in Twins and Women With Bilateral Disease. JCO
26: 4086-4091
[Abstract][Full Text]
Houssami, N., Ciatto, S., Macaskill, P., Lord, S. J., Warren, R. M., Dixon, J. M., Irwig, L.
(2008). Accuracy and Surgical Impact of Magnetic Resonance Imaging in Breast Cancer Staging: Systematic Review and Meta-Analysis in Detection of Multifocal and Multicentric Cancer. JCO
26: 3248-3258
[Abstract][Full Text]
Taira, N., Ohsumi, S., Takabatake, D., Hara, F., Takashima, S., Aogi, K., Takashima, S., Inoue, T., Sugata, S., Nishimura, R.
(2008). Contrast-enhanced CT Evaluation of Clinically and Mammographically Occult Multiple Breast Tumors in Women with Unilateral Early Breast Cancer. Jpn J Clin Oncol
38: 419-425
[Abstract][Full Text]
Hall, F. M.
(2008). The Rise and Impending Decline of Screening Mammography. Radiology
247: 597-601
[Full Text]
Kuhl, C. K.
(2008). The "Coming of Age" of Nonmammographic Screening for Breast Cancer. JAMA
299: 2203-2205
[Full Text]
Gur, D.
(2008). Imaging Technology and Practice Assessment Studies: Importance of the Baseline or Reference Performance Level. Radiology
247: 8-11
[Full Text]
Hoogerbrugge, N., Kamm, Y. J. L., Bult, P., Landsbergen, K. M., Bongers, E. M. H. F., Brunner, H. G., Bonenkamp, H. J., de Hullu, J. A., Ligtenberg, M. J. L., Boetes, C.
(2008). The impact of a false-positive MRI on the choice for mastectomy in BRCA mutation carriers is limited. Ann Oncol
19: 655-659
[Abstract][Full Text]
Bigenwald, R. Z., Warner, E., Gunasekara, A., Hill, K. A., Causer, P. A., Messner, S. J., Eisen, A., Plewes, D. B., Narod, S. A., Zhang, L., Yaffe, M. J.
(2008). Is Mammography Adequate for Screening Women with Inherited BRCA Mutations and Low Breast Density?. Cancer Epidemiol. Biomarkers Prev.
17: 706-711
[Abstract][Full Text]
Orel, S.
(2008). Who Should Have Breast Magnetic Resonance Imaging Evaluation?. JCO
26: 703-711
[Abstract][Full Text]
Buchholz, T. A., Lehman, C. D., Harris, J. R., Pockaj, B. A., Khouri, N., Hylton, N. F., Miller, M. J., Whelan, T., Pierce, L. J., Esserman, L. J., Newman, L. A., Smith, B. L., Bear, H. D., Mamounas, E. P.
(2008). Statement of the Science Concerning Locoregional Treatments After Preoperative Chemotherapy for Breast Cancer: A National Cancer Institute Conference. JCO
26: 791-797
[Abstract][Full Text]
Kim, M. J., Kim, E.-K., Kwak, J. Y., Park, B.-W., Kim, S.-I., Sohn, J., Oh, K. K.
(2008). Role of Sonography in the Detection of Contralateral Metachronous Breast Cancer in an Asian Population. Am. J. Roentgenol.
190: 476-480
[Abstract][Full Text]
Morrow, M.
(2008). Magnetic Resonance Imaging in the Breast Cancer Patient: Curb Your Enthusiasm. JCO
26: 352-353
[Full Text]
Solin, L. J., Orel, S. G., Hwang, W.-T., Harris, E. E., Schnall, M. D.
(2008). Relationship of Breast Magnetic Resonance Imaging to Outcome After Breast-Conservation Treatment With Radiation for Women With Early-Stage Invasive Breast Carcinoma or Ductal Carcinoma in Situ. JCO
26: 386-391
[Abstract][Full Text]
Gralow, J., Ozols, R. F., Bajorin, D. F., Cheson, B. D., Sandler, H. M., Winer, E. P., Bonner, J., Demetri, G. D., Curran, W. Jr, Ganz, P. A., Kramer, B. S., Kris, M. G., Markman, M., Mayer, R. J., Raghavan, D., Ramsey, S., Reaman, G. H., Sawaya, R., Schuchter, L. M., Sweetenham, J. W., Vahdat, L. T., Davidson, N. E., Schilsky, R. L., Lichter, A. S.
(2008). Clinical Cancer Advances 2007: Major Research Advances in Cancer Treatment, Prevention, and Screening--A Report From the American Society of Clinical Oncology. JCO
26: 313-325
[Abstract][Full Text]
Bollet, M. A., Servant, N., Neuvial, P., Decraene, C., Lebigot, I., Meyniel, J.-P., De Rycke, Y., Savignoni, A., Rigaill, G., Hupe, P., Fourquet, A., Sigal-Zafrani, B., Barillot, E., Thiery, J.-P.
(2008). High-Resolution Mapping of DNA Breakpoints to Define True Recurrences Among Ipsilateral Breast Cancers. JNCI J Natl Cancer Inst
100: 48-58
[Abstract][Full Text]
Wollins, D. S., Somerfield, M. R.
(2008). Q and A: Magnetic Resonance Imaging in the Detection and Evaluation of Breast Cancer. J Oncol Pract
4: 18-23
[Full Text]
Kim, M. J., Kim, E.-K., Kwak, J. Y., Park, B.-W., Kim, S.-I., Oh, K. K.
(2008). Bilateral Synchronous Breast Cancer in an Asian Population: Mammographic and Sonographic Characteristics, Detection Methods, and Staging. Am. J. Roentgenol.
190: 208-213
[Abstract][Full Text]
Schnipper, L. E.
(2007). Update in Oncology. ANN INTERN MED
147: 775-782
[Full Text]
Harvey, J. A., Hendrick, R. E., Coll, J. M., Nicholson, B. T., Burkholder, B. T., Cohen, M. A.
(2007). Breast MR Imaging Artifacts: How to Recognize and Fix Them. RadioGraphics
27: S131-S145
[Abstract][Full Text]
Stanwell, P., Mountford, C.
(2007). In Vivo Proton MR Spectroscopy of the Breast. RadioGraphics
27: S253-S266
[Abstract][Full Text]
Hartman, M., Czene, K., Reilly, M., Adolfsson, J., Bergh, J., Adami, H.-O., Dickman, P. W., Hall, P.
(2007). Incidence and Prognosis of Synchronous and Metachronous Bilateral Breast Cancer. JCO
25: 4210-4216
[Abstract][Full Text]
Kuhl, C. K.
(2007). Current Status of Breast MR Imaging * Part 2. Clinical Applications. Radiology
244: 672-691
[Abstract][Full Text]
Pruthi, S., Brandt, K. R., Degnim, A. C., Goetz, M. P., Perez, E. A., Reynolds, C. A., Schomberg, P. J., Dy, G. K., Ingle, J. N.
(2007). A Multidisciplinary Approach to the Management of Breast Cancer, Part 1: Prevention and Diagnosis. Mayo Clin Proc.
82: 999-1012
[Abstract][Full Text]
Mandelblatt, J.
(2007). To Screen or Not to Screen Older Women for Breast Cancer: A New Twist on an Old Question or Will We Ever Invest in Getting the Answers?. JCO
25: 2991-2992
[Full Text]
Garrido-Laguna, I., Fernandez Hidalgo, O., Garcia Foncillas, J., Gyorki, D., Mann, B., Frauscher, F., Sweeney, K. J., Sacchini, V., Nash, I., Marcus, P. M., Fennigkoh, L., Lehman, C. D., Gatsonis, C., Schnall, M. D.
(2007). MRI Evaluation of Breast Cancer. NEJM
357: 191-193
[Full Text]
Hayes, D. F.
(2007). Follow-up of Patients with Early Breast Cancer. NEJM
356: 2505-2513
[Full Text]
(2007). Should MRI Be Performed to Detect Contralateral Breast Cancer?. JWatch Women's Health
2007: 1-1
[Full Text]
(2007). MRI of the Opposite Breast in Women with Breast Cancer. JWatch General
2007: 5-5
[Full Text]
Smith, R. A.
(2007). The Evolving Role of MRI in the Detection and Evaluation of Breast Cancer. NEJM
356: 1362-1364
[Full Text]
(2007). Proceed with Caution: MRI Evaluation in Women with New Breast Cancer. JWatch Oncology and Hematology
2007: 1-1
[Full Text]
Previous
