Evaluation of breast screening strategies in a high risk breast and ovarian cancer clinic
| Autor: | Martha H. Thomas, Christine Garcia, Martha E. Stewart, Kari L. Ring, Susan C. Modesitt, Anne Knisely |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Oncology
medicine.medical_specialty animal structures endocrine system diseases DCIS BRCA Population lcsh:Gynecology and obstetrics lcsh:RC254-282 03 medical and health sciences Breast cancer screening Breast cancer 0302 clinical medicine Internal medicine Medicine Mammography Breast MRI Case Series skin and connective tissue diseases education lcsh:RG1-991 education.field_of_study 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Mammogram BRCA mutation Obstetrics and Gynecology Cancer lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens medicine.disease female genital diseases and pregnancy complications 030220 oncology & carcinogenesis business Ovarian cancer |
| Zdroj: | Gynecologic Oncology Reports, Vol 33, Iss, Pp 100587-(2020) Gynecologic Oncology Reports |
| ISSN: | 2352-5789 |
| DOI: | 10.1016/j.gore.2020.100587 |
| Popis: | Highlights • BRCA mutation carriers are more likely to be diagnosed with breast cancer compared to high-risk non-BRCA carriers. • MRI was able to effectively identify DCIS in the BRCA population. • In BRCA mutation carriers younger than 40, there were no MRI occult cancers found. Recent data suggest that BRCA mutation carriers younger than 40 may not benefit from mammography in addition to MRI. Our objective was to evaluate screening modalities utilized in a high-risk population. Clinicopathologic data were abstracted for patients followed in a high risk clinic from 2007 to 2017. Descriptive statistics were calculated and associations between categorical variables were evaluated using chi-square tests. 631 women comprised the study population; 496 patients had no known mutation (79%), 128 (20%) had a BRCA mutation, and 7 patients had other deleterious mutations. BRCA mutation carriers were more likely to have cancers diagnosed after mammogram callbacks (p = 0.0046) and biopsies (p = 0.0026) compared to non-BRCA mutation carriers. BRCA mutation carriers were also more likely to have cancers diagnosed after biopsies following screening MRI (p = 0.045). 13 BRCA patients were diagnosed with cancer (average age 51). Of the cancers diagnosed after abnormal MRI, 3 were DCIS; all 3 patients had a normal mammogram 4–6 months prior. In those found after abnormal mammogram (n = 6), follow up MRI was performed in 4 cases; all demonstrated the lesion. Three patients were diagnosed younger than 40, 1 on mammogram and 2 on MRI. The patient diagnosed on mammogram had no prior MRI and the lesion was seen on follow-up MRI. Interval screening MRI identified DCIS in BRCA patients with a previous normal mammogram and cancers diagnosed on mammogram were all identified on follow-up MRI. These findings support further evaluation of MRI alone until age 40 in BRCA mutation carriers. |
| Databáze: | OpenAIRE |
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