Dense breast screening: abbreviated breast MRI tops DBT

  • JAMA

  • curated by Miriam Davis, PhD
  • Univadis Clinical Summaries
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Takeaway

  • Abbreviated breast MRI was associated with better breast cancer detection than digital breast tomosynthesis (3D mammography, or DBT) in the EA1141 trial of women with dense breasts undergoing screening.

Why this matters

  • Editorial: Although requiring more research before widespread adoption, abbreviated breast MRI holds promise as a less costly and less time-consuming alternative to conventional MRI for dense breasts.
  • It still requires gadolinium contrast.

Study design

  • A cross-sectional cohort study of women with dense breasts undergoing screening mammography with both DBT and abbreviated MRI, screened in a randomized order and read independently to preclude interpretation bias.
  • Primary outcome: invasive cancer detection rate by biopsy.
  • Funding: NIH; Bracco Diagnostics Inc.

Key results

  • Abbreviated MRI detected invasive breast cancer in all 17 patients who had it, and ductal carcinoma in situ (DCIS) in 5 of 6 women.
  • DBT detected 7 of 17 invasive breast cancers and 2 of 6 DCIS.
  • Abbreviated MRI had a better invasive cancer detection rate: 11.8 vs 4.8 per 1000 women with DBT, for a difference of 7 (exact McNemar P=.002).
  • The sensitivity of abbreviated MRI was 95.7% vs 39.1% with DBT (P=.001); specificity was 86.7% vs 97.4% with DBT (P<.001>

Limitations

  • Abbreviated MRI has low specificity.