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Differences between first and subsequent rounds of the MRISC breast cancer screening program for women with a familial or genetic predisposition
Author(s) -
Kriege Mieke,
Brekelmans Cecile T. M.,
Boetes Carla,
Muller Sara H.,
Zonderland Harmine M.,
Obdeijn Inge Marie,
Manoliu Radu A.,
Kok Theo,
Rutgers Emiel J. T.,
de Koning Harry J.,
Klijn Jan G. M.
Publication year - 2006
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.21863
Subject(s) - medicine , mammography , breast cancer , magnetic resonance imaging , lymph node , radiology , cancer , oncology , gynecology , nuclear medicine
BACKGROUND Within the Dutch MRI Screening (MRISC) study, a Dutch multicenter screening study for hereditary breast cancer, the authors investigated whether previously reported increased diagnostic accuracy of magnetic resonance imaging (MRI) compared with mammography would be maintained during subsequent screening rounds. METHODS From November 1999 to October 2003, 1909 eligible women were included in the study. Screening parameters and tumor characteristics of different rounds were calculated and compared. The authors defined 3 different types of imaging screening rounds: first round in women never screened by imaging before, first round in women screened by imaging (mainly mammography) before, and subsequent rounds. RESULTS The difference in sensitivity for invasive cancers between mammography and MRI was largest in the first round of women previously screened with mammography (20.0 vs. 93.3%; P = .003), but also in subsequent rounds, there was a significant difference in favor of MRI (29.4 vs. 76.5%; P = .02). The difference in false‐positive rate between mammography and MRI was also largest in the first round of women previously screened with mammography (5.5 vs. 14.0%; P <.001), and it remained significant in subsequent rounds (4.6 vs. 8.2%; P <.001). Screen‐detected tumors were smaller and more often lymph node negative than symptomatic tumors in age‐matched control patients, but no major differences in tumor stage were found between tumors detected at subsequent rounds compared with those in the first round. CONCLUSIONS In subsequent rounds, a significantly higher sensitivity and better discriminating capacity of MRI compared with mammography was maintained, and a favorable tumor stage compared with age‐matched symptomatic controls. As results of these subsequent screening rounds were most predictive for long‐term effects, the authors expect that this screening program will contribute to a decrease of breast cancer mortality in these high‐risk women. Cancer 2006. © 2006 American Cancer Society.