TY - JOUR
T1 - Intensive surveillance with biannual dynamic contrast-enhanced magnetic resonance imaging downstages breast cancer in BRCA1 mutation carriers
AU - Guindalini, Rodrigo Santa Cruz
AU - Zheng, Yonglan
AU - Abe, Hiroyuki
AU - Whitaker, Kristen
AU - Yoshimatsu, Toshio F.
AU - Walsh, Tom
AU - Schacht, David V
AU - Kulkarni, Kirti
AU - Sheth, Deepa
AU - Verp, Marion S.
AU - Bradbury, Angela R.
AU - Churpek, Jane
AU - Obeid, Elias
AU - Mueller, Jeffrey
AU - Khramtsova, Galina
AU - Liu, Fang
AU - Raoul, Akila
AU - Cao, Hongyuan
AU - Romero, Iris L.
AU - Hong, Susan
AU - Livingston, Robert
AU - Jaskowiak, Nora
AU - Wang, Xiaoming
AU - Debiasi, Marcio
AU - Pritchard, Colin C.
AU - King, Mary Claire
AU - Karczmar, Gregory
AU - Newstead, Gillian M.
AU - Huo, Dezheng
AU - Olopade, Olufunmilayo I.
N1 - Funding Information:
T. Walsh is a consultant/advisory board member for Color Genomics. D. Sheth reports receiving commercial research grants from Guerbet. E. Obeid reports receiving commercial research grants from Merck and Gen-entech, and is a consultant/advisory board member for Incyte and Pfizer. O.I. Olopade holds ownership interest (including patents) in CancerIQ. No potential conflicts of interest were disclosed by the other authors.
Funding Information:
Special thanks to all the women who enrolled in this study as far back as 2004 and the breast program advocates at The University of Chicago who provided much needed guidance and patient perspective for this study. The authors thank Dr. Gini Fleming for her service as the Data and Safety Study Monitor. The study was supported through funding from the National Cancer Institute grant P50CA125183, the Ralph and Marian Falk Medical Research Trust, Susan G. Komen for the Cure SAC110026, Breast Cancer Research Foundation, and the Housewares Charity Foundation (awarded to O.I. Olopade). M.C. King and O.I. Olopade are American Cancer Society Professors.
Publisher Copyright:
© 2018 American Association for Cancer Research.
PY - 2019
Y1 - 2019
N2 - Purpose: To establish a cohort of high-risk women undergoing intensive surveillance for breast cancer. Experimental Design: We performed dynamic contrast-enhanced MRI every 6 months in conjunction with annual mammography (MG). Eligible participants had a cumulative lifetime breast cancer risk 20% and/or tested positive for a pathogenic mutation in a known breast cancer susceptibility gene. Results: Between 2004 and 2016, we prospectively enrolled 295 women, including 157 mutation carriers (75 BRCA1, 61 BRCA2); participants' mean age at entry was 43.3 years. Seventeen cancers were later diagnosed: 4 ductal carcinoma in situ (DCIS) and 13 early-stage invasive breast cancers. Fifteen cancers occurred in mutation carriers (11 BRCA1, 3 BRCA2, 1 CDH1). Median size of the invasive cancers was 0.61 cm. No patients had lymph node metastasis at time of diagnosis, and no interval invasive cancers occurred. The sensitivity of biannual MRI alone was 88.2% and annual MG plus biannual MRI was 94.1%. The cancer detection rate of biannual MRI alone was 0.7% per 100 screening episodes, which is similar to the cancer detection rate of 0.7% per 100 screening episodes for annual MG plus biannual MRI. The number of recalls and biopsies needed to detect one cancer by biannual MRI were 2.8 and 1.7 in BRCA1 carriers, 12.0 and 8.0 in BRCA2 carriers, and 11.7 and 5.0 in non-BRCA1/2 carriers, respectively. Conclusions: Biannual MRI performed well for early detection of invasive breast cancer in genomically stratified high-risk women. No benefit was associated with annual MG screening plus biannual MRI screening.
AB - Purpose: To establish a cohort of high-risk women undergoing intensive surveillance for breast cancer. Experimental Design: We performed dynamic contrast-enhanced MRI every 6 months in conjunction with annual mammography (MG). Eligible participants had a cumulative lifetime breast cancer risk 20% and/or tested positive for a pathogenic mutation in a known breast cancer susceptibility gene. Results: Between 2004 and 2016, we prospectively enrolled 295 women, including 157 mutation carriers (75 BRCA1, 61 BRCA2); participants' mean age at entry was 43.3 years. Seventeen cancers were later diagnosed: 4 ductal carcinoma in situ (DCIS) and 13 early-stage invasive breast cancers. Fifteen cancers occurred in mutation carriers (11 BRCA1, 3 BRCA2, 1 CDH1). Median size of the invasive cancers was 0.61 cm. No patients had lymph node metastasis at time of diagnosis, and no interval invasive cancers occurred. The sensitivity of biannual MRI alone was 88.2% and annual MG plus biannual MRI was 94.1%. The cancer detection rate of biannual MRI alone was 0.7% per 100 screening episodes, which is similar to the cancer detection rate of 0.7% per 100 screening episodes for annual MG plus biannual MRI. The number of recalls and biopsies needed to detect one cancer by biannual MRI were 2.8 and 1.7 in BRCA1 carriers, 12.0 and 8.0 in BRCA2 carriers, and 11.7 and 5.0 in non-BRCA1/2 carriers, respectively. Conclusions: Biannual MRI performed well for early detection of invasive breast cancer in genomically stratified high-risk women. No benefit was associated with annual MG screening plus biannual MRI screening.
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U2 - 10.1158/1078-0432.CCR-18-0200
DO - 10.1158/1078-0432.CCR-18-0200
M3 - Article
C2 - 30154229
AN - SCOPUS:85063000849
SN - 1078-0432
VL - 25
SP - 1786
EP - 1794
JO - Clinical Cancer Research
JF - Clinical Cancer Research
IS - 6
ER -