The frequency of missed breast cancers in women participating in a high-risk MRI screening program

AbstractPurposeTo evaluate the frequency of missed cancers on breast MRI in women participating in a high-risk screening program.MethodsPatient files from women who participated in an increased risk mammography and MRI screening program (2003 –2014) were coupled to the Dutch National Cancer Registry. For each cancer detected, we determined whether an MRI scan was available (0–24 months before cancer detection), which was reported to be negative. These negative MRI scans were in consensus re-evaluated by two dedicated breast radiolog ists, with knowledge of the cancer location. Cancers were scored as invisible, minimal sign, or visible. Additionally, BI-RADS scores, background parenchymal enhancement, and image quality (IQ; perfect, sufficient, bad) were determined. Results were stratified by detection mode (mammography, MRI, in terval cancers, or cancers in prophylactic mastectomies) and patient characteristics (presence ofBRCA mutation, age, menopausal state).ResultsNegative prior MRI scans were available for 131 breast cancers. Overall 31% of cancers were visible at the initially negative MRI scan and 34% of cancers showed a minimal sign. The presence of aBRCA mutation strongly reduced the likelihood of visible findings in the last negative MRI (19 vs. 46%,P 
Source: Breast Cancer Research and Treatment - Category: Cancer & Oncology Source Type: research

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