Lehman Constance D
Department of Radiology, University of Washington School of Medicine, Seattle Cancer Care Alliance, Seattle, Washington 98109-1023, USA.
J Magn Reson Imaging. 2006 Nov;24(5):964-70. doi: 10.1002/jmri.20752.
Breast cancer is diagnosed in over one million women worldwide every year. Until breast cancer can be prevented, early detection offers the best chance for cure. Mammographic screening is an effective method for early detection in average-risk women. However, the sensitivity of mammography is decreased in women at high risk for breast cancer. Because of its high sensitivity, multiple investigators have studied the potential role of MRI in screening women at high risk. In the past few years, results from eight major clinical trials exploring breast MRI as a screening tool have been published. Combined, the studies included 4271 patients and found 144 breast cancers detected by MRI, for an overall cancer yield of 3%. The sensitivity of MRI ranged from 71% to 100% across the studies. Although its reported specificity was variable, the call-back rates and risk of benign biopsies were within acceptable limits. In general, patients who underwent breast MRI screening had a 10% risk of being called back, and a 5% risk of having a benign biopsy. This work reviews the literature and current practices and recommendations for MRI as a screening tool for high-risk women.
全球每年有超过100万女性被诊断出患有乳腺癌。在乳腺癌能够被预防之前，早期检测提供了治愈的最佳机会。乳腺钼靶筛查是普通风险女性早期检测的有效方法。然而，对于乳腺癌高风险女性，乳腺钼靶的敏感性会降低。由于其高敏感性，多位研究者探讨了MRI在高风险女性筛查中的潜在作用。在过去几年中，八项探索乳腺MRI作为筛查工具的主要临床试验结果已发表。综合来看，这些研究纳入了4271名患者，通过MRI检测出144例乳腺癌，总体癌症检出率为3%。各项研究中MRI的敏感性范围为71%至100%。尽管其报告的特异性有所不同，但召回率和良性活检风险在可接受范围内。一般来说，接受乳腺MRI筛查的患者有10%的召回风险和5%的良性活检风险。本文回顾了关于MRI作为高风险女性筛查工具的文献、当前实践及建议。
