Breast cancer size estimation with MRI in BRCA mutation carriers and other high risk patients

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Title:	Breast cancer size estimation with MRI in BRCA mutation carriers and other high risk patients
Author(s):	Mann, R.M. ; Bult, P. ; Laarhoven, H.W.M. van ; Span, P.N. ; Schlooz, M.; Veltman, J. ; Hoogerbrugge, N.
Publication year:	2013
Source:	European Journal of Radiology, vol. 82, iss. 9, (2013), pp. 1416-1422
ISSN:	0720-048X
DOI:	http://dx.doi.org/10.1016/j.ejrad.2013.03.003
Publication type:	Article / Letter to editor
Please use this identifier to cite or link to this item : http://hdl.handle.net/2066/132041
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Subject:	IGMD 6: Hormonal regulation ONCOL 5: Aetiology, screening and detection ONCOL 1: Hereditary cancer and cancer-related syndromes ONCOL 1: Hereditary cancer and cancer-related syndromes NCMLS 6: Genetics and epigenetic pathways of disease ONCOL 3: Translational research
Organization:	Radiology Pathology Medical Oncology Radiation Oncology Laboratory of Genetic, Endocrine and Metabolic Diseases Human Genetics
Journal title:	European Journal of Radiology
Volume:	vol. 82
Issue:	iss. 9
Page start:	p. 1416
Page end:	p. 1422
Abstract:	OBJECTIVE: To assess the value of breast MRI in size assessment of breast cancers in high risk patients, including those with a BRCA 1 or 2 mutation. Guidelines recommend invariably breast MRI screening for these patients and therapy is thus based on these findings. However, the accuracy of breast MRI for staging purposes is only tested in sporadic cancers. METHODS: We assessed concordance of radiologic staging using MRI with histopathology in 49 tumors in 46 high risk patients (23 BRCA1, 12 BRCA2 and 11 Non-BRCA patients). The size of the total tumor area (TTA) was compared to pathology. In invasive carcinomas (n=45) the size of the largest focus (LF) was also addressed. RESULTS: Correlation of MRI measurements with pathology was 0.862 for TTA and 0.793 for LF. TTA was underestimated in 8(16%), overestimated in 5(10%), and correctly measured in 36(73%) cases. LF was underestimated in 4(9%), overestimated in 5(11%), and correctly measured in 36(80%) cases. Impact of BRCA 1 or 2 mutations on the quality of size estimation was not observed. CONCLUSIONS: Tumor size estimation using breast MRI in high risk patients is comparable to its performance in sporadic cancers. Therefore, breast MRI can safely be used for treatment planning.