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  • March 2007

    Benefits of Breast MRI in Women with Contralateral Breast Cancer

    New England Journal of Medicine | Constance D. Lehman et al.

    Article:

    MRI Evaluation of the Contralateral Breast in Women with Recently Diagnosed Breast Cancer

    Authors:

    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

    Journal:

    New England Journal of Medicine, March 29, 2007

    Summary:

    A 2007 study conducted by Lehman et al, on behalf of the American College of Radiology Imaging Network (ACRIN), compared the diagnostic efficacy of magnetic resonance imaging (MRI) to that of standard clinical evaluation and/or mammography in the detection of contralateral breast cancer. Despite undergoing clinical and mammographic evaluation, up to 10% of women who have been treated for unilateral breast cancer are soon after diagnosed with cancer in the contralateral (opposite) breast. Lehman et al selected a cohort of 969 women recently diagnosed with unilateral breast cancer (based on clinical and mammographic evaluation) to undergo breast MRI, in order to determine MRI’s diagnostic efficacy. If MRI detected a previously occult cancer, presence of the cancer was verified via biopsy within 12 months of the study entry. If MRI did not detect contralateral cancer, the absence was verified by means of biopsy, along with repeat imaging or clinical examination (or both) upon 1 year of follow-up.

    The additional breast MRI detected otherwise occult contralateral cancer in 30 of the 969 women (3.1%), proving that MRI can indeed identify cancer otherwise missed by traditional clinical examinations or mammography. 40% of the cancers detected by MRI were ductal carcinomas in situ, tumors which can progress to invasive disease if left untreated. In addition, MRI also had an extremely high negative predictive value: 99%.

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