Abbreviated protocol of magnetic resonance imaging for detecting breast cancer in dense breasts

doi:10.3877/cma.j.issn.1674-0807.2016.03.007

Abstract

Abstract:

Objective

To evaluate the application of an abbreviated protocol (AP) of MRI for detecting breast cancer in patients with dense breast tissue.

Methods

In this study, we retrospectively analyzed the clinical data of patients in Suzhou Hospital, Nanjing Medical University from September 2014 to June 2015. Totally 172 patients with dense breast tissue screened in mammography (MG) received dynamic contrast-enhanced MRI [AP and full diagnostic protocol (FDP) ] and needle biopsy. AP consisted of the first postcontrast subtraction and the maximum-intensity projection; FDP consisted of all MRI dynamic enhanced images. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) of MG,AP and FDP for breast cancer detection were calculated in dense breasts. The diagnostic capabilities of the three methods were compared using the receiver operating characteristic (ROC) curve.

Results

Totally 56 cases of breast cancer were detected in 172 patients with dense breasts, including 12 cases of DCIS,37 invasive ductal carcinoma,2 invasive lobular carcinoma, 3 medullary carcinoma and 2 colloid carcinoma.Nineteen cases were detected with breast cancer by MG, 53 cases by AP and 55 cases by FDP, with the sensitivity of 33.9%(19/56),94.6%(53/56) and 98.2% (55/56),the specificity of 49.1% (57/116),79.3% (92/116) and 91.4 % (106/116), PLR of 0.67,4.57 and 11.42, and NLR of 1.35, 0.07 and 0.02, respectively. ROC curves showed that area under the curve was 0.679±0.053 in MG,0.930±0.026 in AP and 0.948±0.023 in FDP, with 95% confidence interval of 0.574-0.784, 0.881-0.980 and 0.900-0.994 respectively. The area under the curve of AP or FDP was significantly by bigger than that of MG (Z=3.031,3.497,bothP＜0.050), while no significant difference was found between AP and FDP (Z=1.114,P＞0.050).

Conclusion

AP and FDP have higher diagnostic capability for detecting breast cancer in dense breasts compared with MG, and AP may be applied in breast cancer screening.

Key words: Breast neoplasms, Magnetic resonance spectroscopy, Radiography

Shuangqingi Chen, Min Huang, Yuying Shen, Qing Cai, Chuanxiao Xu, Chenlu Liu, Xiaohu You. Abbreviated protocol of magnetic resonance imaging for detecting breast cancer in dense breasts[J]. Chinese Journal of Breast Disease(Electronic Edition), 2016, 10(03): 155-160.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhrxbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-0807.2016.03.007

https://zhrxbzz.cma-cmc.com.cn/EN/Y2016/V10/I03/155

Figures/Tables 4

References 25

[1]	Pollán M, Ascunce N, Ederra M, et al. Mammographic density and risk of breast cancer according to tumor characteristics and mode of detection: a Spanish population-based case-control study[J]. Breast Cancer Res,2013,29,15(1): R9.
[2]	Harnett A, Smallwood J, Titshall V, et al. Diagnosis and treatment of early breast cancer, including locally advanced disease-summary of NICE guidance[J]. BMJ,2009,338:b438.
[3]	Berg WA. How well does supplemental screening magnetic resonance imaging work in high-risk women [J]. J Clin Oncol, 2014, 32(21):2193-2196.
[4]	Kuhl CK, Schrading S, Strobel K, et al. Abbreviated breast magnetic resonance imaging (MRI): first postcontrast subtracted images and maximum-intensity projection-a novel approach to breast cancer screening with MRI[J]. J Clin Oncol,2014,32(22):2304-2310.
[5]	Morris EA. Rethinking breast cancer screening: ultra FAST breast magnetic resonance imaging [J]. J Clin Oncol, 2014, 32 (22):2281-2283.
[6]	Ojeda-Fournier H, Nguyen JQ. How to improve your breast cancer program: standardized reporting using the new American College of Radiology Breast Imaging-Reporting and Data System[J]. Indian J Radiol Imaging,2009,19(4):266-277.
[7]	孙军,陈峰,郑凯尔. ROC 曲线分析在放射学中的应用[J]. 中华放射学杂志,2001,35(8):574-577.
[8]	Aberle DR,Chiles C,Gatsonis C,et al. Imaging and cancer:research strategy of the American College of Radiology Imaging Network[J].Radiology,2005,235(3):741-751.
[9]	Jemal A, Siegel R, Xu J, et al. Cancer statistics, 2010[J]. CA Cancer J Clin,2010,60(5):277-300.
[10]	Brower V. Homing in on mechanisms linking breast density to breast cancer risk[J]. J Natl Caneer Inst,2010,102(12):843-845.
[11]	Kerlikowske K. The mammogram that cried Wolfe[J].N Engl J Med,2007,356(3):297-300.
[12]	Harvey JA, Bovbjerg VE. Quantitative assessment of mammographic breast density: relationship with breast cancer risk[J]. Radiology,2004,230(1):29-41.
[13]	Boyd NF, Rommens JM, Vogt K, et al. Mammographic breast density as an intermediate phenotype for breast cancer[J]. Lancet Oncol,2005,6(10):798-808.
[14]	Carney PA, Miglioretti DL, Yankaskas BC, et al. Individual and combined effects of age, breast density, and hormone replacement therapy use on the accuracy of screening mammography[J]. Ann Intern Med,2003,138(3):168-175.
[15]	Graf O, Berg WA, Sickle EA. Large rodlike calcifications at mammography: analysis of morphologic features [J]. AJR Am J Roentgenol,2013,200(2):299-303.
[16]	Mandelson MT, Oestreicher N, Porter PL, et al. Breast density as a predictor of mammographic detection: comparison of interval- and screen-detected cancers[J]. J Natl Cancer Inst, 2000, 92(13):1081-1087.
[17]	Roubidoux MA, Bailey JE, Wray LA, et al. Invasive cancers detected after breast cancer screening yielded a negative result: relationship of mammographic density to tumor prognostic factors[J]. Radiology,2004,230(1):42-48.
[18]	Mendelson MT, Oestreicher N, Porter PL, et al. Breast density as a predictor of mammographic detection: comparison of interval-and screen-detected cancers[J]. J Natl Cancer Inst, 2000, 92(13):1081-1087.
[19]	Tudorica LA, Oh KY, Roy N, et al. A feasible high spatiotemporal resolution breast DCE-MRI protocol for clinical settings[J]. Magn Reson Imaging,2012,30(9):1257-1267.
[20]	Berg WA, Zhang Z, Lehrer D, et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk[J]. JAMA,2012,307(13):1394-1404.
[21]	Game JP, Aspegren K, Balldin G, et al. Increasing incidence of and declining mortality from breast carcinoma. trends in Malm, Sweden,1961-1992[J]. Cancer,1997,79(1):69-74.
[22]	Moore SG, Shenoy PJ, Fanucchi L, et al. Cost-effectiveness of MRI compared to mammography for breast cancer screening in a high risk population[J]. BMC Health Serv Res,2009,9:9.
[23]	Heywang SH, Wolf A, Pruss E, et al. MR imaging of the breast with Gd-DTPA: use and limitations[J]. Radiology,1989,171(1):95-103.
[24]	Varga D, Wöckel A, Wagner J, et al. Value of ultrasound in preoperative local staging in early breast cancer[J]. Ultraschall Med,2011,32(4):387-392.
[25]	U.S. Preventive Services Task Force. Screening for breast cancer: U.S. Preventive Services Task Force recommendation statement[J]. Ann Intern Med,2009,151(10):716-726.

Please choose a citation manager

Content to export