Posy Jane Seifert DO, Presenter: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc Consultant, Philips Electronics NV Advisory Board, Hologic, Inc

Stamatia V. Destounis MD, Abstract Co-Author: Investigator, Siemens AG Investigator, FUJIFILM Holdings Corporation Investigator, Hologic, Inc Investigator, Koning Corporation Advisory Board, Philips Electronics NV Advisory Board, Matakina International Limited

Patricia Somerville MD, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

Philip F. Murphy MD, Abstract Co-Author: Investigator, FUJIFILM Holdings Corporation Investigator, Koning Corporation Investigator, Hologic, Inc

To determine the incidence of breast cancer in patients presenting for high risk breast MRI screening due to a personal history.

Retrospective review of patients presenting for high risk breast MRI screening from 2003 to 2010. A total of 1,502 high risk MRI patients were reviewed; revealing 796 having a personal history of breast cancer. Thirteen of these patients had abnormal MRI enhancements, which were mammographically occult, with a subsequent cancer diagnosis; these comprise the study cohort. For these 13 patients data recorded included patient demographics, risk assessment (including personal and family history), BI-RADS® breast density, lesion characteristics (type, size), biopsy method and correlation with surgical pathology.

A total of 13 patients comprise the study cohort. Average patient age was 56 years (range 43 to 78). Breast density consisted of 5 scattered, 2 heterogeneously dense and 6 extremely dense. 69% of patients reported post-menopausal status, and 85% of patients reported no hormone usage. Ethnic background consisted of 85% Caucasian, 8% Asian and 8% Hispanic. The new MRI enhancements ranged in size from 3mm to 50mm. Of the abnormalities on MRI, 38% (n=5) were in the contralateral breast, 54% (n=7) in the ipsilateral breast; one patient had findings in both the contralateral and ipsilateral breast. All of the ipsilateral findings were in patients who had prior lumpectomy; 4 of whom did not receive radiation therapy. All new findings underwent biopsy; 5 MRI-guided biopsy, 6 second look ultrasound-guided biopsy. One patient had fine needle aspiration biopsy and 1 patient underwent open surgical biopsy. All biopsies revealed carcinoma; 85% (n=11) invasive and 15% (n=2) DCIS.  

MRI is a useful screening tool in women with a personal history of breast cancer. This small cohort shows that MRI is significant as it revealed invasive cancer in 85% of enhancing lesions. This is significant as one of the main criticisms against breast MRI in women with a personal history of the disease is that it is thought to lead to unnecessary tests and overtreatment for mostly negligible disease.

Breast MRI is beneficial in women with a personal history of breast cancer as it can identify new mammographically occult disease.

Seifert, P, Destounis, S, Somerville, P, Murphy, P, Incidence of Breast Cancers Detected by High Risk Screening MRI in Women with a Personal History of Breast Cancer.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11005339.html