New MR imaging biomarker predicts breast cancer risk

  • Arasu VA & al.
  • J Clin Oncol
  • 9 Jan 2019

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

  • An elevation in breast parenchymal enhancement (BPE) on MRI predicts future invasive breast cancer risk.
  • Elevated BPE indicates uptake of gadolinium-based intravenous contrast and may reflect increased tissue microvascularity and/or permeability regulated by endogenous hormones.
  • The association between BPE and breast cancer is independent of breast density, an established biomarker of breast cancer risk.

Why this matters

  • This study adds to the evidence that elevated BPE should be considered for risk prediction in women undergoing breast MRI.

Study design

  • Prospective cohort of 4247 women without breast cancer in the Breast Cancer Surveillance Consortium.
  • BPE was qualitatively assessed by radiologists according to criteria of the American College of Radiology.
  • BPE was categorized as minimal, mild, moderate, or marked.
  • Funding: NIH; PCORI; AHRQ.

Key results

  • 176 women developed breast cancer over a median follow-up of 2.8 years.
  • Having mild, moderate, or marked BPE (vs minimal BPE) was associated with nearly thrice the risk of invasive breast cancer (HR, 2.73; 95% CI, 1.66-4.49), but not ductal carcinoma in situ.
  • Increasing levels of BPE were associated with higher cancer risk, indicating dose-response.
  • Low breast density but mild, moderate, or marked BPE was associated with increased breast cancer risk (HR, 2.30; 95% CI, 1.19-4.46).

Limitations

  • Reliance on qualitative assessment.
  • Observational design.

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