Grubstein Ahuva, Rapson Yael, Benzaquen Oshra, Rozenblatt Shira, Gadiel Itay, Atar Eli, Yerushalmi Rinat, Cohen Matan J
Department of Imaging, Rabin Medical Center - Beilinson Hospital, Petach Tikva 4941492, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 6997801, Israel; Institute of Oncology, Davidoff Cancer Center, Rabin Medical Center, Petach Tikva 4941492, Israel.
Clin Imaging. 2018 Sep-Oct;51:347-351. doi: 10.1016/j.clinimag.2018.06.010. Epub 2018 Jun 30.
High background parenchymal enhancement and amount of fibroglandular tissue on breast magnetic resonance imaging are related to increased breast cancer risk. This study sought to compare these parameters between BRCA mutation carriers and non-carriers and to evaluate the potential implications of the findings for short term follow-up.
Magnetic resonance imaging studies of known BRCA mutation carriers, were compared to age-matched non-carrier studies performed in the same center during the same period. The groups were compared for qualitative background parenchymal enhancement and amount of fibroglandular tissue using the Breast Imaging Reporting and Data System (BI-RADS).
Breast parenchymal enhancement was high in up to one-third of the cohort: 22% of carriers and 33% of controls (p = 0.013). These results were sustained on separate analysis of menstrual-cycle-timed examinations. Amount of fibroglandular tissue was high in most cases: 62% of carriers and 75% of controls (p = 0.004). A BI-RADS final assessment score of 3 was more common in patients with high parenchymal enhancement, especially controls.
BRCA mutation carriers demonstrated lower levels of breast parenchymal enhancement and amount of fibroglandular tissue than age-matched non-carriers. These differences are probably influenced by hormonal status, as well as highlight different risks in distinctive subgroups of breast cancer (hormone-enriched, mutation-associated defective DNA damage repair), affecting considerations of preventive medical treatment. Differences in the indications for imaging between the carrier and non-carrier groups (screening for mutations and breast cancer evaluation, respectively) probably accounted for the higher rate of BI-RADS 3 in the control group.
乳腺磁共振成像中高背景实质强化和纤维腺组织量与乳腺癌风险增加相关。本研究旨在比较BRCA突变携带者和非携带者之间的这些参数，并评估这些发现对短期随访的潜在影响。
将已知BRCA突变携带者的磁共振成像研究与同期在同一中心进行的年龄匹配的非携带者研究进行比较。使用乳腺影像报告和数据系统（BI-RADS）比较两组的定性背景实质强化和纤维腺组织量。
高达三分之一的队列中乳腺实质强化较高：22%的携带者和33%的对照者（p = 0.013）。在对月经周期定时检查的单独分析中，这些结果持续存在。大多数情况下纤维腺组织量较高：62%的携带者和75%的对照者（p = 0.004）。BI-RADS最终评估评分为3在实质强化高的患者中更常见，尤其是对照者。
与年龄匹配的非携带者相比，BRCA突变携带者的乳腺实质强化水平和纤维腺组织量较低。这些差异可能受激素状态影响，也突出了乳腺癌不同亚组（富含激素、与突变相关的DNA损伤修复缺陷）中的不同风险，影响预防性医疗的考虑。携带者和非携带者组之间成像指征的差异（分别为筛查突变和评估乳腺癌）可能是对照组中BI-RADS 3率较高的原因。
