In a single-institution retrospective analysis reported in the Journal of Clinical Oncology, Weinstein et al identified the prevalent cancer detection rate associated with supplemental abbreviated breast magnetic resonance imaging (MRI) screening among average-risk women with dense breasts who had negative/benign findings on digital breast tomosynthesis. The study involved women referred for abbreviated breast MRI at the Hospital of the University of Pennsylvania who underwent imaging between January 2016 and February 2019.
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Key Findings
The study population consisted of 475 asymptomatic women with dense breasts who had negative/benign digital breast tomosynthesis examinations and underwent supplementary screening with abbreviated breast MRI.
On abbreviated breast MRI screening, 420 women (88.4%) had negative/benign findings, 13 (2.7%) were recommended for short-interval follow-up, and 42 (8.8%) were recommended for biopsy.
Of 39 completed biopsies, 12 (38.9%) identified malignancies in 12 women, consisting of 7 with invasive carcinomas and 5 with ductal carcinoma in situ. An additional patient was diagnosed with invasive ductal carcinoma by biopsy recommended at 6-month follow-up. The positive predictive value 2 (PPV2) was 28.6% (12 of 42 recommended biopsies); PPV3 was 30.8% (12 of 39 completed biopsies).
The cancer detection rate on abbreviated breast MRI was 27.4 cases per 1,000 women (13 of 475; 95% confidence interval [CI] = 16.1–46.3). No interval cancers were found at 1-year follow-up. Thus, the sensitivity of abbreviated breast MRI was determined to be 100% (13 of 13; 95% CI = 77.2%–100%), and the specificity was 90.9% (420 of 462; 95% CI = 87.9%–93.2%).
The size of invasive carcinomas ranged from 0.6 cm to 1.0 cm. Among seven women undergoing surgical evaluation of the axilla, none had positive nodes.
The investigators concluded: “Preliminary results from clinical implementation of screening abbreviated breast MRI resulted in a cancer detection rate of 27.4/1,000 at the patient level after digital breast tomosynthesis in women with dense breasts. Additional evaluation is warranted.”
Susan P. Weinstein, MD, of the Perelman School of Medicine, University of Pennsylvania, is the corresponding author of the Journal of Clinical Oncology article.
Disclosure: For full disclosures of the study authors, visit ascopubs.org.
