Weinstock Chana, Campassi Cristina, Goloubeva Olga, Wooten Kathleen, Kesmodel Susan, Bellevance Emily, Feigenberg Steven, Ioffe Olga, Tkaczuk Katherine H R
University of Maryland Greenebaum Cancer Center, 22 South Greene Street, RM S9D, Baltimore, MD 21201 USA.
Springerplus. 2015 Aug 28;4:459. doi: 10.1186/s40064-015-1158-5. eCollection 2015.
As the breast cancer survivor population increases, the topic of screening these women for recurrences is increasingly relevant. In our institution, we use both breast MRI and mammography in the surveillance of breast cancer survivors, although little data exists on the use of MRI in this setting. We present a retrospective analysis of our experience and compare the sensitivity and specificity of MRI vs. mammography in this setting.
We identified women under 65 with a history of breast cancer and at least one follow-up MRI performed along with a mammogram done within 6 months of the MRI. We compared the outcomes of MRI and mammography in terms of biopsies performed as well as in detection of new cancers.
Of 617 charts reviewed, 249 patients met inclusion criteria, with 571 paired MRI/mammogram results. There were 27 biopsies performed due to MRI findings alone, 10 done due to mammographic findings alone, and 15 done based on abnormalities seen on both imaging modalities. There were 8 malignancies identified based on an abnormal MRI, 3 detected on both MRI and mammography, and none identified via mammography alone. Overall, MRI had a sensitivity of 84.6% (the 95% CI 54.6-98.1) and a specificity of 95.3% (the 95% CI 93.3-96.9); mammography a sensitivity of 23.1% (the 95% CI 5.0-53.8), and a specificity of 96.4% (the 95% CI 94.5-97.8).
Breast MRI is a useful surveillance modality in breast cancer survivors and may be more sensitive at detecting recurrences than mammography alone in this population.
随着乳腺癌幸存者人数的增加，对这些女性进行复发筛查的话题越来越重要。在我们机构，我们在乳腺癌幸存者的监测中同时使用乳腺磁共振成像（MRI）和乳房X线摄影，尽管在这种情况下关于MRI使用的数据很少。我们对我们的经验进行回顾性分析，并比较MRI与乳房X线摄影在这种情况下的敏感性和特异性。
我们确定了年龄在65岁以下、有乳腺癌病史且至少进行过一次随访MRI检查以及在MRI检查后6个月内进行过乳房X线摄影的女性。我们比较了MRI和乳房X线摄影在活检结果以及新癌症检测方面的结果。
在审查的617份病历中，249名患者符合纳入标准，有571对MRI/乳房X线摄影结果。仅因MRI结果进行了27次活检，仅因乳房X线摄影结果进行了10次活检，基于两种成像方式均发现的异常进行了15次活检。基于MRI异常确定了8例恶性肿瘤，MRI和乳房X线摄影均检测到3例，仅通过乳房X线摄影未发现恶性肿瘤。总体而言，MRI的敏感性为84.6%（95%置信区间54.6 - 98.1），特异性为95.3%（95%置信区间93.3 - 96.9）；乳房X线摄影的敏感性为23.1%（95%置信区间5.0 - 53.8），特异性为96.4%（95%置信区间94.5 - 97.8）。
乳腺MRI是乳腺癌幸存者有用的监测方式，在该人群中检测复发可能比单独使用乳房X线摄影更敏感。
