Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features

Fiona J. Gilbert, Ruth M. L. Warren, Gek Kwan-Lim, Deborah J. Thompson, Ros A. Eeles, D. Gareth Evans, Martin O. Leach, United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group

Research output: Contribution to journalArticle

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Abstract

PURPOSE: To review imaging features of screening-detected cancers on images from diagnostic and prior examinations to identify specific abnormalities to aid earlier detection of or facilitate differentiation of cancers in BRCA1 and BRCA2 carriers and in women with a high risk for breast cancer.

MATERIALS AND METHODS: Informed consent and multicenter and local research ethics committee approval were obtained. Women (mean age, 40.1 years; range, 27-55 years) who had at least a 50% risk of being a BRCA1, BRCA2, or TP53 gene mutation carrier were recruited from August 1997 to March 2003 into the United Kingdom Magnetic Resonance Imaging in Breast Screening Study Group trial and were offered annual magnetic resonance (MR) imaging and two-view mammography (total number of screenings, 2065 and 1973; mean, 2.38 and 2.36, respectively). Images in all 39 cancer cases were reread in consensus to document the morphologic and enhancement imaging features on MR and mammographic images in screening and prior examinations. Cases were grouped into genetic subtypes.

RESULTS: With MR imaging, there was no difference in morphologic or enhancement characteristics between the genetic subgroups. Cancers on images from prior examinations were of smaller size, showed less enhancement, and were more likely to have a type 1 enhancement curve compared with those cancers in the subsequent diagnostic screening examinations. The tumor sizes detected by using MR imaging and mammography were not significantly different (P = .46). The cancers in BRCA1 carriers found by using MR imaging tended to be smaller than those detected by using mammography (median, 17 mm vs 30 mm; P = .37), whereas the opposite was true for cancers found in BRCA2 carriers (MR imaging median size = 12.5 mm vs mammographic median size = 6 mm; P = .067); the difference was not significant. Tumors with prior MR imaging abnormalities grew at an average of 5.1 mm/y.

CONCLUSION: When undertaking MR imaging surveillance in high-risk women, small enhancing lesions should be regarded with suspicion and biopsied or patients should be followed up at 6 months.
Original languageEnglish
Pages (from-to)358-368
Number of pages11
JournalRadiology
Volume252
Issue number2
DOIs
Publication statusPublished - 1 Aug 2009

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Magnetic Resonance Imaging
Breast Neoplasms
Neoplasms
Mammography
BRCA2 Gene
BRCA1 Gene
Research Ethics Committees
p53 Genes
Informed Consent
Early Detection of Cancer
Breast
Magnetic Resonance Spectroscopy
Mutation

Keywords

  • adult
  • BRCA1 protein
  • BRCA2 protein
  • breast neoplasms
  • female
  • genetic predisposition to disease
  • Great Britain
  • heterozygote
  • humans
  • magnetic resonance imaging
  • mammography
  • risk assessment
  • risk factors
  • tumor suppressor protein p53

Cite this

Gilbert, F. J., Warren, R. M. L., Kwan-Lim, G., Thompson, D. J., Eeles, R. A., Evans, D. G., ... United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group (2009). Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features. Radiology, 252(2), 358-368. https://doi.org/10.1148/radiol.2522081032

Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer : MR imaging and mammographic features. / Gilbert, Fiona J.; Warren, Ruth M. L.; Kwan-Lim, Gek; Thompson, Deborah J.; Eeles, Ros A.; Evans, D. Gareth; Leach, Martin O. ; United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group.

In: Radiology, Vol. 252, No. 2, 01.08.2009, p. 358-368.

Research output: Contribution to journalArticle

Gilbert, FJ, Warren, RML, Kwan-Lim, G, Thompson, DJ, Eeles, RA, Evans, DG, Leach, MO & United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group 2009, 'Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features', Radiology, vol. 252, no. 2, pp. 358-368. https://doi.org/10.1148/radiol.2522081032
Gilbert, Fiona J. ; Warren, Ruth M. L. ; Kwan-Lim, Gek ; Thompson, Deborah J. ; Eeles, Ros A. ; Evans, D. Gareth ; Leach, Martin O. ; United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group. / Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer : MR imaging and mammographic features. In: Radiology. 2009 ; Vol. 252, No. 2. pp. 358-368.
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abstract = "PURPOSE: To review imaging features of screening-detected cancers on images from diagnostic and prior examinations to identify specific abnormalities to aid earlier detection of or facilitate differentiation of cancers in BRCA1 and BRCA2 carriers and in women with a high risk for breast cancer. MATERIALS AND METHODS: Informed consent and multicenter and local research ethics committee approval were obtained. Women (mean age, 40.1 years; range, 27-55 years) who had at least a 50{\%} risk of being a BRCA1, BRCA2, or TP53 gene mutation carrier were recruited from August 1997 to March 2003 into the United Kingdom Magnetic Resonance Imaging in Breast Screening Study Group trial and were offered annual magnetic resonance (MR) imaging and two-view mammography (total number of screenings, 2065 and 1973; mean, 2.38 and 2.36, respectively). Images in all 39 cancer cases were reread in consensus to document the morphologic and enhancement imaging features on MR and mammographic images in screening and prior examinations. Cases were grouped into genetic subtypes. RESULTS: With MR imaging, there was no difference in morphologic or enhancement characteristics between the genetic subgroups. Cancers on images from prior examinations were of smaller size, showed less enhancement, and were more likely to have a type 1 enhancement curve compared with those cancers in the subsequent diagnostic screening examinations. The tumor sizes detected by using MR imaging and mammography were not significantly different (P = .46). The cancers in BRCA1 carriers found by using MR imaging tended to be smaller than those detected by using mammography (median, 17 mm vs 30 mm; P = .37), whereas the opposite was true for cancers found in BRCA2 carriers (MR imaging median size = 12.5 mm vs mammographic median size = 6 mm; P = .067); the difference was not significant. Tumors with prior MR imaging abnormalities grew at an average of 5.1 mm/y. CONCLUSION: When undertaking MR imaging surveillance in high-risk women, small enhancing lesions should be regarded with suspicion and biopsied or patients should be followed up at 6 months.",
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T1 - Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer

T2 - MR imaging and mammographic features

AU - Gilbert, Fiona J.

AU - Warren, Ruth M. L.

AU - Kwan-Lim, Gek

AU - Thompson, Deborah J.

AU - Eeles, Ros A.

AU - Evans, D. Gareth

AU - Leach, Martin O.

AU - United Kingdom Magnetic Resonance Imaging in Breast Screening (MARIBS) Study Group

PY - 2009/8/1

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N2 - PURPOSE: To review imaging features of screening-detected cancers on images from diagnostic and prior examinations to identify specific abnormalities to aid earlier detection of or facilitate differentiation of cancers in BRCA1 and BRCA2 carriers and in women with a high risk for breast cancer. MATERIALS AND METHODS: Informed consent and multicenter and local research ethics committee approval were obtained. Women (mean age, 40.1 years; range, 27-55 years) who had at least a 50% risk of being a BRCA1, BRCA2, or TP53 gene mutation carrier were recruited from August 1997 to March 2003 into the United Kingdom Magnetic Resonance Imaging in Breast Screening Study Group trial and were offered annual magnetic resonance (MR) imaging and two-view mammography (total number of screenings, 2065 and 1973; mean, 2.38 and 2.36, respectively). Images in all 39 cancer cases were reread in consensus to document the morphologic and enhancement imaging features on MR and mammographic images in screening and prior examinations. Cases were grouped into genetic subtypes. RESULTS: With MR imaging, there was no difference in morphologic or enhancement characteristics between the genetic subgroups. Cancers on images from prior examinations were of smaller size, showed less enhancement, and were more likely to have a type 1 enhancement curve compared with those cancers in the subsequent diagnostic screening examinations. The tumor sizes detected by using MR imaging and mammography were not significantly different (P = .46). The cancers in BRCA1 carriers found by using MR imaging tended to be smaller than those detected by using mammography (median, 17 mm vs 30 mm; P = .37), whereas the opposite was true for cancers found in BRCA2 carriers (MR imaging median size = 12.5 mm vs mammographic median size = 6 mm; P = .067); the difference was not significant. Tumors with prior MR imaging abnormalities grew at an average of 5.1 mm/y. CONCLUSION: When undertaking MR imaging surveillance in high-risk women, small enhancing lesions should be regarded with suspicion and biopsied or patients should be followed up at 6 months.

AB - PURPOSE: To review imaging features of screening-detected cancers on images from diagnostic and prior examinations to identify specific abnormalities to aid earlier detection of or facilitate differentiation of cancers in BRCA1 and BRCA2 carriers and in women with a high risk for breast cancer. MATERIALS AND METHODS: Informed consent and multicenter and local research ethics committee approval were obtained. Women (mean age, 40.1 years; range, 27-55 years) who had at least a 50% risk of being a BRCA1, BRCA2, or TP53 gene mutation carrier were recruited from August 1997 to March 2003 into the United Kingdom Magnetic Resonance Imaging in Breast Screening Study Group trial and were offered annual magnetic resonance (MR) imaging and two-view mammography (total number of screenings, 2065 and 1973; mean, 2.38 and 2.36, respectively). Images in all 39 cancer cases were reread in consensus to document the morphologic and enhancement imaging features on MR and mammographic images in screening and prior examinations. Cases were grouped into genetic subtypes. RESULTS: With MR imaging, there was no difference in morphologic or enhancement characteristics between the genetic subgroups. Cancers on images from prior examinations were of smaller size, showed less enhancement, and were more likely to have a type 1 enhancement curve compared with those cancers in the subsequent diagnostic screening examinations. The tumor sizes detected by using MR imaging and mammography were not significantly different (P = .46). The cancers in BRCA1 carriers found by using MR imaging tended to be smaller than those detected by using mammography (median, 17 mm vs 30 mm; P = .37), whereas the opposite was true for cancers found in BRCA2 carriers (MR imaging median size = 12.5 mm vs mammographic median size = 6 mm; P = .067); the difference was not significant. Tumors with prior MR imaging abnormalities grew at an average of 5.1 mm/y. CONCLUSION: When undertaking MR imaging surveillance in high-risk women, small enhancing lesions should be regarded with suspicion and biopsied or patients should be followed up at 6 months.

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KW - genetic predisposition to disease

KW - Great Britain

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KW - humans

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KW - mammography

KW - risk assessment

KW - risk factors

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