Comparison of Abbreviated MRI with Mammography and Ultrasound in Women with a Personal History of Breast Cancer

Abstract

Rationale and objectives: To compare abbreviated MRI with mammography and US for screening in women with a personal history of breast cancer. In addition, the first and subsequent rounds of abbreviated MRI were compared.

Materials and methods: The Institutional Review Board approved this retrospective study. Nine hundred and thirty-nine abbreviated MRI scans of 710 women with a personal history of breast cancer were included (mean age, 54.1±9.4 years). The diagnostic performances of abbreviated MRI, mammography, and US for the detection of the second breast cancer were compared. When more than one round of abbreviated MRI was performed, we compared the scans of the first and subsequent rounds.

Results: There were 15 (2.1%) cases of second breast cancer. Thirty-nine of the 939 abbreviated MRI scans were diagnosed as positive; of them, 11 were diagnosed as breast cancer, with a PPV₂ of 28.2% (US, 19.0%; mammography, 28.6%). The AUC, sensitivity, and cancer detection rate (per 1000) were the highest for abbreviated MRI (0.829, 68.8% and 11.7) (US: 0.616, 25.0%, and 4.3; mammography: 0.560, 12.5%, and 2.1, respectively). Two hundred women underwent multiple rounds of abbreviated MRI. AUC, PPV₂, and the cancer detection rates were higher during the subsequent rounds (0.987, 45.5, and 21.8) than during the first round (0.605, 11.1, and 5).

Conclusion: Abbreviated MRI for women with a personal history of breast cancer was more sensitive for the diagnosis of second breast cancer than US or mammography. In addition, subsequent rounds of MRI showed better performance than the first round.

Keywords: Breast cancer; MRI; Screening; US, Mammography.