Breast MRI provides value for high-risk breast cancer patients after negative DBT
Breast MRI’s performance when screening women at a high-risk for breast cancer after negative digital breast tomosynthesis (DBT) results is similar to its performance after negative 2D digital mammography results, according to new findings published in the American Journal of Roentgenology. This, the authors explained, indicates that breast MRI still provides value as more and more specialists shift from digital mammography to DBT.
“As DBT is increasingly being used as the primary breast cancer screening modality, the question arises if the proven benefits of screening with breast MRI when used as an adjunct to conventional full-field digital mammography (FFDM) are maintained when used as an adjunct to DBT,” wrote Ashley A. Roark, MD, Baylor College of Medicine in Houston, Texas, and colleagues. “To our knowledge, no prior study has evaluated breast MRI screening in women at higher-than-average risk for breast cancer in the era of DBT screening.”
Roark and colleagues reviewed data from more than 4,400 screening breast MRI examinations. More than 2,200 were from patients who had negative FFDM results, and more than 2,100 were from patients with negative DBT results. Overall, there was “no significant difference” in the two patient groups. In the FFDM group, breast MRI helped specialists diagnose 11 cancers per 1,000 examinations. In the DBT group, there were 16 cancers per 1,000 examinations. Most of the cancers were invasive and less than 1 centimeter.
“Our results suggest that despite the modest increase in cancer detection reported for DBT over FFDM, patients at higher-than-average risk screened with DBT continue to benefit from supplemental screening with breast MRI,” the authors wrote.
The researchers did note that there were limitations to their study. It was a retrospective study, for instance, and restricted to a single academic center. Also, they added, it is possible some patient data ended up being included in both patient cohorts.
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