Women with a personal history of breast cancer have an elevated lifetime risk for a second breast cancer. However, the current American Cancer Society guidelines do not recommend MRI screening in this population. Multiple studies have demonstrated that the sensitivity of Abbreviated breast MRI (AB-MRI) is similar to full diagnostic protocols (FDP-MRI). In this study, we retrospectively evaluate the use of surveillance AB-MRI in women with a personal history of breast cancer.

An IRB approved and HIPAA compliant reader study was performed on 398 consecutive women with a personal history of breast cancer who underwent full protocol clinical breast MRIs from 9/13-12/15. There were 14 cancers detected (3.8%). An enriched reader study was performed consisting of 68 cases including the 14 cancer cases. Non-cancer cases had at least 1 year of follow-up. Interpretations from a limited image set simulating an AB-MR protocol (T2, pre, and post contrast) were compared with interpretations of the FDP-MRI clinical study.

The AB-MR interpretations were compared with those from the full, clinical protocol. The sensitivity (SN), specificity(SP), positive predictive value (PPV), and the negative predictive value (NPV) for the simulated AB-MR vs the FDP-MRI interpretations were: SN -50% vs 71%, SP - 96% vs 77%, PPV- 74% vs 43%, NPV - 88% vs. 91%. The mean difference between reader 1 and reader 2 was 0.29 with 95% confidence interval: [-0.33, 0.90]. There were significantly fewer false positives with AB-MRI than FDP-MRI, but more false negatives were observed with AB-MRI.

Our preliminary results show higher specificity at the expense of sensitivity in our simulated AB-MRI reads compared to FDP-MRI in women with a history of breast cancer. Further evaluation is warranted.

A simulated AB-MRI protocol resulted in fewer false positive exams than with a full, clinical MR protocol in women with a personal history of breast cancer, however, more research is needed.