Stamatia V. Destounis MD, Presenter: Investigator, FUJIFILM Holdings Corporation Investigator, Seno Medical Instruments, Inc

Andrea Lynn Arieno BS, Abstract Co-Author: Nothing to Disclose

Renee Morgan RT, Abstract Co-Author: Nothing to Disclose

Jennifer Gruttadauria, Abstract Co-Author: Nothing to Disclose

To review patients undergoing high risk breast MRI due to personal history of pre-menopausal breast cancer and to determine the incidence of additional cancers found.

With Institutional Review Board approval and waiver of informed consent, a retrospective review was conducted to determine patients diagnosed with pre-menopausal breast cancer undergoing screening high risk MRI. 296 High risk MRI exams were performed in 127 patients from 2003 to 2014. Data recorded included patient age and breast density, lesion size on MRI (if applicable), type of biopsy procedure (if applicable), and pathology results (if applicable).

Total number of MRI exams performed per patient ranged from 1 to 8. Average patient age at the time of first cancer diagnosis was 40.6 years (range 19-48). 76% of patients had heterogeneously dense or extremely dense breast tissue. Of 296 exams, there were 68 (23%) suspicious MRI findings. 47 needle biopsy procedures were performed (69%); 3 did not have a biopsy and proceeded to surgery. MRI biopsy was performed in 30 and ultrasound biopsy in 13. One stereotactic biopsy was performed and FNAC was performed in 3. The remaining 18 findings were determined to be benign by targeted ultrasound, were no longer visualized when MRI biopsy was attempted or were followed and remained stable. Pathology revealed 15 malignancies (10 invasive and 5 non-invasive), 30 benign findings, and 5 atypical findings. Of those diagnosed with cancer, average time between diagnoses was 6.6 years (range 3-16). Seven cancers were in the ipsilateral breast; 5 were of the same pathology as the original malignancy and 2 were different. Eight new cancers were diagnosed in the contralateral breast.  

Screening MRI in patients with a personal history of pre-menopausal breast cancer detected a new suspicious finding in 23% of exams. Of 127 patients screened, malignancy was detected in 15 (12%). The cancer diagnoses were detected up to 16 years after initial diagnosis, which demonstrates the importance of monitoring these patients. 

Monitoring women with a history of pre-menopausal breast cancer is important as these patients are at increased risk of a second breast cancer diagnosis. 

Destounis, S, Arieno, A, Morgan, R, Gruttadauria, J, Importance of MRI Monitoring of Patients with a History of Pre-menopausal Breast Cancer.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14001752.html