Women with a personal history of breast cancer need to go through an annual screening with MRI along with mammography, recommends a new study.
The American Cancer Society (ACS) guidelines have recommended annual screening with breast MRI in women with a known gene mutation or with a strong family history indicating a lifetime risk of breast cancer greater than 20 percent.
However, the guidelines said there is insufficient evidence to recommend for or against MRI screening in women who have already had breast cancer themselves.
"In our study using breast MRI screening, we actually detected proportionally more cancers in women with a personal history of breast cancer, compared with those women with a genetic mutation or strong family history who are currently recommended to have breast MRI," said Wendy B. DeMartini of the University of Washington
"Further, women with a personal history were less likely to be recalled for additional testing and less likely to have a biopsy for a false positive MRI finding," said DeMartini.
DeMartini and colleagues performed a retrospective review of initial screening breast MRI examinations of 1,026 women from January 2004 to June 2009. Of the 1,026 women, 327 had a genetic or family history of breast cancer and 646 had a personal history of treated breast cancer.
The cancer yield in the women with a personal history of breast cancer (3.1 percent) was double that of the women with a genetic or family history (1.5 percent).
Specificity in women with a personal history was 93.6 percent, compared with 86.3 percent for the other group. Specificity refers to the accuracy of the exam in correctly ruling out cancer where it is not present, resulting in lower recall and biopsy rates due to false-positive findings.
"Our findings show that the diagnostic performance of MRI in patients with a personal history of treated breast cancer supports consideration of screening MRI as an adjunct to mammography," said DeMartini.
The findings were presented at the annual meeting of the Radiological Society of North America (RSNA).