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Breast MRI Effective at Detecting Cancer in Dense Breasts

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February 1, 2023 — Compared to other common supplemental screening methods, Breast MRI It was superior at detecting breast cancer in women with dense breasts, according to a study published in . RadiologyJournal of the Radiological Society of North America (RSNA).

breast cancer It is one of the leading causes of cancer death in women. Approximately 47% of women in the United States have dense breasts, which is an independent risk factor for breast cancer. Women with dense breasts have a higher amount of glandular and fibrous connective tissue and a lower amount of adipose tissue in their breasts.

now showing Mammography is up to 98% effective in detecting cancers in fatty breasts, but tends to miss breast cancers in dense breasts. This results in a negative mammogram and gives the patient a false sense of security.

“A breast cancer mass appears white on a mammogram, and dense tissue also appears white, making it difficult for radiologists to find breast cancer within dense breast tissue,” said the co-authors of the study. Vivian FreitasMD, M.Sc., Assistant Professor University of Toronto, Canadaand staff radiologists Joint Medical Imaging Division in Toronto.

Women with dense breasts may need additional screening to help detect cancer. Her four most common supplemental imaging tests are handheld breast ultrasound, automated breast ultrasound, digital breast tomosynthesis, and breast MRI.

“Our study was designed to assess the role of different supplemental screening tests in women with negative screening mammograms and dense breast tissue at average or intermediate risk for breast cancer,” Dr. Freitas said. said.

To determine which screening modalities were most beneficial for women with dense breasts, researchers performed a meta-analysis of 22 studies involving 261,233 patients screened for breast cancer. Ten studies reported on handheld breast ultrasound, four on automated breast ultrasound, three on breast MRI, and eight on digital breast tomosynthesis. Of the included patients, 132,166 patients had dense breasts and negative mammograms.

Risk assessment models have been used to identify patients at average and intermediate risk of developing breast cancer. In the United States, a woman with an estimated lifetime risk of developing breast cancer of 12-13% of her is considered average risk. Factors that increase the moderate risk include prior breast cancer treatment and previous breast biopsies with high-risk lesions. High-risk patients with a lifetime risk of ≥20% were excluded from the study. This is because the benefits of breast MRI have already been established in high-risk populations.

A meta-analysis showed that among 132,166 patients with dense breast, a total of 541 breast cancers initially missed by mammography were detected by complementary screening modalities. Breast MRI was an excellent screening method and was able to detect even the smallest cancers. Except for MRI, there were no significant differences between other complementary screening modalities.

“MRI is far superior to handheld ultrasound, automated ultrasound, and digital breast tomosynthesis in terms of cancer detection,” Dr. Freitas said. “Our results on the role of MRI in supplemental screening will allow stakeholders to guide health policy and direct further research in this setting.”

This result demonstrates the efficacy of breast MRI in cancer detection, but further research is needed.

“The cost-effectiveness, mortality reduction, and other benefits of breast MRI compared to other techniques need to be further evaluated before advocating broader application of breast MRI in these women,” Dr. Freitas said. Stated. “Currently, the availability and cost of breast MRI are the biggest barriers to widespread adoption.”

For more information: www.rsna.org

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Contrast-enhanced mammography vs. MRI: response to neoadjuvant therapy in breast cancer.

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Video: Explaining Dense Breasts — Interview with Dr. Christiane Kuhl

Video: Use of Breast MRI Improves Cancer Detection in Dense Breasts in Dutch Study — Interview with Dr. Gillian Newsted

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