Women who have a personal history of breast cancer benefit most from abbreviated MRI during follow-up imaging appointments, new research published in Academic Radiology suggests.
Post-treatment follow-up care is crucial for breast cancer patients, as these individuals have an increased risk of secondary cancer. If the latter goes undetected, the disease is more likely to become invasive and thus carries an increased mortality risk. Diagnostic mammograms are commonly ordered after initial treatment, but the surgery and radiation required in treating cancers can alter the modality's diagnostic performance. Some have suggested alternative screening measures in these cases.
“Recently, the American College of Radiology appropriateness criteria suggest that women with intermediate lifetime risk, including those with a personal history of breast cancer, may also benefit from supplemental screening, such as digital breast tomosynthesis or breast magnetic resonance imaging,” corresponding author Yeong Yi An, MD, with the Department of Radiology at St. Vincent's Hospital, and co-authors explained.
Digital breast tomosynthesis (DBT) and abbreviated MRI (AB-MRI) both yield good diagnostic performance for detecting breast cancer, but researchers wanted to evaluate each modality’s potential for identifying secondary cancers during surveillance imaging after patients have received treatment.
To achieve this, the experts examined scans of 471 patients who had undergone both DBT and AB-MRI. They then compared the modalities’ cancer detection rates (CDR), sensitivity, specificity, positive-predictive values (PPV), negative predictive values (NPV) and accuracy in identifying secondary cancers.
A total of 11 new malignancies were detected in the scans. AB-MRI was able to detect all 11, while DBT identified only six recurrences. AB-MRI also significantly outperformed DBT when it came to specificity, PPV, NPV, accuracy and sensitivity, achieving 100% sensitivity compared to 54.6% with DBT.
“Our study results suggest that AB-MRI could potentially be sufficient for post-treatment surveillance,” the experts said.
The researchers noted that although their findings are positive, the serious implications of detecting secondary cancers merit larger, multi-institutional prospective studies before AB-MRI can be adopted more broadly.
You can view the full research here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.