Summary: Follow-up AB-MR screenings in dense breasts showed reduced abnormalities and maintained high cancer detection rates, supporting sequential AB-MR for supplemental screening, particularly due to the prevalence of early-stage, node-negative cancers.

Key Takeways:

  1. Follow-up AB-MR screenings in dense breasts demonstrated a significant decrease in abnormal interpretation rates while sustaining high cancer detection rates.
  2. All cancers identified in subsequent-round AB-MR screenings were early-stage and node-negative, underscoring the potential of sequential AB-MR for supplementary screening in dense breast populations.
  3. Notably, follow-up AB-MR screenings exhibited a considerable decrease in abnormal interpretation rates (7.8% vs. 17.4%) while maintaining a high cancer detection rate (12.1 vs. 18.9 per 1000), with all detected cancers at stage 0 or 1 and no lymph node involvement.

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According to the American Journal of Roentgenology (AJR), follow-up abbreviated breast MRI (AB-MR) screenings in patients with dense breasts showed a reduced abnormal interpretation rate (AIR) compared to initial exams, while still maintaining a high cancer detection rate (CDR).

Promise in Dense Breast Screening

Pointing out that all cancers detected by subsequent-round examinations were early-stage node-negative cancers, “further investigations are warranted to optimize the screening interval,” notes first author Christine E. Edmonds, MD, assistant professor of radiology at the Hospital of the University of Pennsylvania. “The findings support sequential AB-MR for supplemental screening in individuals with dense breasts.”

Lower Abnormal Rates, Consistent Cancer Detection

Edmonds and her colleagues’ accepted manuscript in AJR-focused on patients with dense breasts and average breast cancer risk who received AB-MR for extra screening from Dec. 20, 2016, to May 10, 2023. By analyzing clinical interpretations and biopsy recommendations from EMR data, the researchers compared initial and follow-up AB-MR screenings.

In women with dense breasts, follow-up AB-MR screenings for additional screening resulted in a lower abnormal interpretation rate (AIR) compared to initial screenings (7.8% vs. 17.4%, p <.001), while still maintaining a high cancer detection rate (CDR) (12.1 vs. 18.9 per 1000, p =.37). All cancers detected by follow-up AB-MR were at stage 0 or 1, with sizes ranging from 0.3 to 1.2 cm, and showed no involvement of lymph nodes.

Featured image: A. Axial subtracted contrast-enhanced fat-suppressed T1-weighted image from baseline AB-MR examination is negative (BI-RADS category 1). B. Axial subtracted contrast-enhanced fat-suppressed T1-weighted image from subsequent-round AB-MR examination performed 2 years later shows new 5-mm enhancing mass in upper outer right breast (arrow), which was not seen on mammogram performed 5 months prior. Examination was assessed as BI-RADS category 5. Ultrasound-guided core biopsy yielded invasive ductal carcinoma (ER+/PR+/HER2-).