Breast Cancer Mortality among Women with a or Mutation in a Magnetic Resonance Imaging Plus Mammography Screening Program.

Annual breast magnetic resonance imaging (MRI) plus mammography is the standard of care for screening women with inherited mutations. However, long-term breast cancer-related mortality with screening is unknown. Between 1997 and June 2011, 489 previously unaffected mutation carriers aged 25 to 65 years were screened with annual MRI plus mammography on our study.

A Metric for Reducing False Positives in the Computer-Aided Detection of Breast Cancer from Dynamic Contrast-Enhanced Magnetic Resonance Imaging Based Screening Examinations of High-Risk Women.

Magnetic resonance imaging (MRI)-enabled cancer screening has been shown to be a highly sensitive method for the early detection of breast cancer. Computer-aided detection systems have the potential to improve the screening process by standardizing radiologists to a high level of diagnostic accuracy. This retrospective study was approved by the institutional review board of Sunnybrook Health Sciences Centre.

Semi-automatic region-of-interest segmentation based computer-aided diagnosis of mass lesions from dynamic contrast-enhanced magnetic resonance imaging based breast cancer screening.

Cancer screening with magnetic resonance imaging (MRI) is currently recommended for very high risk women. The high variability in the diagnostic accuracy of radiologists analyzing screening MRI examinations of the breast is due, at least in part, to the large amounts of data acquired. This has motivated substantial research towards the development of computer-aided diagnosis (CAD) systems for breast MRI which can assist in the diagnostic process by acting as a second reader of the examinations.

A vector machine formulation with application to the computer-aided diagnosis of breast cancer from DCE-MRI screening examinations.

This study investigates the use of a proposed vector machine formulation with application to dynamic contrast-enhanced magnetic resonance imaging examinations in the context of the computer-aided diagnosis of breast cancer. This paper describes a method for generating feature measurements that characterize a lesion's vascular heterogeneity as well as a supervised learning formulation that represents an improvement over the conventional support vector machine in this application. Spatially varying signal-intensity measures were extracted from the examinations using principal components analysis and the machine learning technique known as the support vector machine (SVM) was used to classify the results.

Supine breast MRI.

Purpose: To achieve high-quality unilateral supine breast magnetic resonance imaging (MRI) as a step to facilitate image aiding of clinical applications, which are often performed in the supine position. Contrast-enhanced breast MRI is a powerful tool for the diagnosis of cancer. However, prone patient positioning typically used for breast MRI hinders its use for image aiding.

Psychological impact of recall on women with BRCA mutations undergoing MRI surveillance.

Objective: The addition of magnetic resonance imaging (MRI) to mammography for surveillance of women with BRCA mutations significantly increases sensitivity but lowers specificity. This study aimed to examine whether MRI surveillance, and particularly recall, is associated with increased anxiety, depression, or breast cancer worry/distress.

Methods: Women with BRCA mutations in an MRI surveillance study were invited to complete: Hospital Anxiety and Depression Scale (HADS), Lerman's Breast Cancer Worry Scale, Breast Cancer Worry Interference Scale, and a quality of life rating at 3 time points: 1-2 weeks before (T1), 4-6 weeks after (T2) and 6 months after their annual surveillance (T3).

Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging.

Purpose: The sensitivity of magnetic resonance imaging (MRI) for breast cancer screening exceeds that of mammography. If MRI screening reduces mortality in women with a BRCA1 or BRCA2 mutation, it is expected that the incidence of advanced-stage breast cancers should be reduced in women undergoing MRI screening compared with those undergoing conventional screening.

Patients And Methods: We followed 1,275 women with a BRCA1 or BRCA2 mutation for a mean of 3.

Improvement in DCIS detection rates by MRI over time in a high-risk breast screening study.

Although magnetic resonance imaging (MRI) is much more sensitive than mammography for detecting early invasive breast cancer, in many high-risk screening studies MRI was less sensitive than mammography for detecting ductal carcinoma in situ (DCIS). We reviewed our experience detecting DCIS in our single center study of annual MRI, mammography, ultrasound and clinical breast examination (CBE) for screening very high-risk women. All cases of DCIS±microinvasion and invasive cancer were compared in two time frames: before (period A) and after (period B) July 2001-when we acquired expertise in the detection of DCIS with MRI-with respect to patient demographics, method of detection, and rates of detection of invasive cancer and DCIS.

Preoperative breast magnetic resonance imaging: controversies arising in the quest to evaluate clinical benefit.

Breast magnetic resonance imaging (MRI) is indisputably the highest sensitivity test available to detect breast cancer, revealing more extensive cancer in the ipsilateral and otherwise occult cancer in the contralateral breasts when used before surgery. The use of preoperative breast MRI has become somewhat controversial, because the clinical benefit of the heightened detection provided by MRI has been questioned in the context of multidisciplinary breast cancer treatment, relatively low local recurrence, and metachronous contralateral cancer rates. Also, MRI detection rates have been compared with the high rates reported in the pathology literature.

Willingness of breast cancer survivors to participate in a randomized controlled trial of digital mammography with or without MRI as breast cancer surveillance: a feasibility study.

Breast MRI is often used for surveillance of breast cancer (BC) survivors despite the lack of evidence in this population. We surveyed younger BC survivors to evaluate their willingness to participate in a randomized controlled trial (RCT) of annual digital mammography with or without MRI. Median age of the 348 participants was 51 years; 45% had undergone diagnostic MRI.

Effect of the enhancement threshold on the computer-aided detection of breast cancer using MRI.

Rationale And Objectives: To evaluate the effect that variations in the enhancement threshold have on the diagnostic accuracy of two computer-aided detection (CAD) systems for magnetic resonance based breast cancer screening.

Materials And Methods: Informed consent was obtained from all patients participating in cancer screening and this study was approved by the participating institution's review board. This retrospective study was nested in a prospective, single-institution, high-risk, breast screening study involving dynamic contrast-enhanced magnetic resonance imaging.

Women with locally advanced breast cancer are not at higher risk for contralateral synchronous breast cancer.

Breast magnetic resonance imaging (MRI) may provide a more accurate assessment of synchronous contralateral breast cancer in select cohorts of patients. The utility of this imaging technique for detecting synchronous contralateral breast cancers in patients with locally advanced breast cancer (LABC) has not previously been described. We report our experience in assessing contralateral disease in a cohort of women with LABC who had clinical assessment, mammography, ultrasound, and MRI prior to neo-adjuvant therapy.

Is mammography adequate for screening women with inherited BRCA mutations and low breast density?

Background: Several observational studies have shown that magnetic resonance imaging (MRI) is significantly more sensitive than mammography for screening women over age 25 at high risk for hereditary breast cancer; however, MRI is more costly and less specific than mammography. We sought to determine the extent to which the low sensitivity of mammography is due to greater breast density.

Methods: Breast density was evaluated for all patients on a high-risk screening study who were diagnosed with breast cancer between November 1997 and July 2006.

BRCA1 mutation and young age predict fast breast cancer growth in the Dutch, United Kingdom, and Canadian magnetic resonance imaging screening trials.

Purpose: Magnetic resonance imaging (MRI) screening enables early detection of breast cancers in women with an inherited predisposition. Interval cancers occurred in women with a BRCA1 mutation, possibly due to fast tumor growth. We investigated the effect of a BRCA1 or BRCA2 mutation and age on the growth rate of breast cancers, as this may influence the optimal screening frequency.

MR imaging-guided breast localization system with medial or lateral access.

Purpose: To evaluate the degree of error of the authors' magnetic resonance (MR) imaging-guided needle localization system for biopsy of suspicious lesions visualized only with MR imaging, by using both prospectively recorded and retrospectively reviewed data, including MR imaging lesion coordinates as the reference standard, and to determine whether any lesion or breast characteristics affect this error.

Materials And Methods: Institutional review board approval, along with informed consent, was obtained as directed by the board. In 31 patients (age range, 34-64 years; mean age, 54.

Diagnostic architectural and dynamic features at breast MR imaging: multicenter study.

Purpose: To prospectively determine the prevalence and predictive value of three-dimensional (3D) and dynamic breast magnetic resonance (MR) imaging and contrast material kinetic features alone and as part of predictive diagnostic models.

Materials And Methods: The study protocol was approved by the institutional review board or ethics committees of all participating institutions, and informed consent was obtained from all participants. Although study data collection was performed before HIPAA went into effect, standards that would be compliant with HIPAA were adhered to.

MRI detection of distinct incidental cancer in women with primary breast cancer studied in IBMC 6883.

Background: Prior single institution studies suggest MRI may improve the assessment of the extent of cancer within the breast, and thus reduce the risk of leaving macroscopic disease in the breast following breast conservation therapy. We report on the rate of MRI and mammography detection of foci of distinct incidental cancer in a prospective, multi center trial involving 426 women with confirmed breast cancer at 15 institutions in the US, Canada, and Germany.

Methods: Women underwent mammography and MRI prior to biopsy of the suspicious index lesion.

Magnetic resonance imaging of the breast prior to biopsy.

Context: Breast magnetic resonance imaging (MRI) has been shown to have high sensitivity for cancer detection and is increasingly used following mammography to evaluate suspicious breast lesions.

Objective: To determine the accuracy of breast MRI in conjunction with mammography for the detection of breast cancer in patients with suspicious mammographic or clinical findings.

Design, Setting, And Patients: Prospective multicenter investigation of the International Breast MR Consortium conducted at 14 university hospitals in North America and Europe from June 2, 1998, through October 31, 2001, of 821 patients referred for breast biopsy for American College of Radiology category 4 or 5 mammographic assessment or suspicious clinical or ultrasound finding.