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Comparison of false positive rates for screening breast magnetic resonance imaging (MRI) in high risk women performed on stacked versus alternating schedules.

Othman E, Wang J, Sprague BL, Rounds T, Ji Y, Herschorn SD, Wood ME - Springerplus (2015)

Bottom Line: Screening was considered stacked if both studies were performed within 90 days and alternating if studies were 4-8 months apart.The FP rates were similar for the two schedules when considering BI-RAD 4, 5, 0 or biopsy as a positive test.False positive rates differ based on the type of exam (baseline or subsequent) and definition of positive but do not differ based on imaging schedule (stacked or alternating); suggesting that women and their providers may choose the imaging schedule they prefer.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Vermont, Burlington, VT USA.

ABSTRACT

Purpose: Breast MRI added to mammography increases screening sensitivity for high-risk women but false-positive (FP) rates are higher and the optimal screening schedule for coordination with mammography is unclear. We compare rates of FP MRI when studies were performed on two different schedules.

Patients and methods: High-risk women at the University of Vermont who had at least 1 MRI and 1 mammogram performed within one year between 2004-2012 were eligible for inclusion in this study. Screening was considered stacked if both studies were performed within 90 days and alternating if studies were 4-8 months apart. False positive was defined in one of three ways.

Results: 137 women had screening which met inclusion criteria and 371 MRIs were reviewed. The FP rates were similar for the two schedules when considering BI-RAD 4, 5, 0 or biopsy as a positive test. FP rates were significantly higher for the stacked schedule (18.2 vs. 10.2%, p = 0.026) when considering BI-RADS 3-4-5-0 as positive test, due to the elevated rate of BI-RADS 3 assessments among stacked exams.

Conclusion: False positive rates differ based on the type of exam (baseline or subsequent) and definition of positive but do not differ based on imaging schedule (stacked or alternating); suggesting that women and their providers may choose the imaging schedule they prefer. This is significant as a randomized clinical trial comparing the two schedules is not likely to be performed, given the high cost and large number of women needed for such a study.

No MeSH data available.


Consort diagram for population screened.
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Fig1: Consort diagram for population screened.

Mentions: The records of 599 women at increased risk of developing breast cancer and enrolled in the parent database at the University of Vermont from May 1st, 2004 to March 31st, 2012 were reviewed. 440 women did not have a breast MRI as part of their screening, 16 women who had breast MRI performed to evaluate mammographic findings were excluded; an additional 6 women were excluded because they did not have an MRI and mammogram performed within one year. Therefore, 137 women met the inclusion criteria and are the subject of this analysis. See Figure 1 for a consort diagram of study participants. The mean age of women at the time of initial screening breast MRI was 45.8; 78.8% were premenopausal. High risk was attributed to strong family history of breast cancer in 87.6%, BRCA mutation in 18.3%, and prior atypical biopsy in 13.1%. The median number of surveillance cycles was 2 (range of 1 to 7). Table 1 outlines the characteristics of the participants.Figure 1


Comparison of false positive rates for screening breast magnetic resonance imaging (MRI) in high risk women performed on stacked versus alternating schedules.

Othman E, Wang J, Sprague BL, Rounds T, Ji Y, Herschorn SD, Wood ME - Springerplus (2015)

Consort diagram for population screened.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4340856&req=5

Fig1: Consort diagram for population screened.
Mentions: The records of 599 women at increased risk of developing breast cancer and enrolled in the parent database at the University of Vermont from May 1st, 2004 to March 31st, 2012 were reviewed. 440 women did not have a breast MRI as part of their screening, 16 women who had breast MRI performed to evaluate mammographic findings were excluded; an additional 6 women were excluded because they did not have an MRI and mammogram performed within one year. Therefore, 137 women met the inclusion criteria and are the subject of this analysis. See Figure 1 for a consort diagram of study participants. The mean age of women at the time of initial screening breast MRI was 45.8; 78.8% were premenopausal. High risk was attributed to strong family history of breast cancer in 87.6%, BRCA mutation in 18.3%, and prior atypical biopsy in 13.1%. The median number of surveillance cycles was 2 (range of 1 to 7). Table 1 outlines the characteristics of the participants.Figure 1

Bottom Line: Screening was considered stacked if both studies were performed within 90 days and alternating if studies were 4-8 months apart.The FP rates were similar for the two schedules when considering BI-RAD 4, 5, 0 or biopsy as a positive test.False positive rates differ based on the type of exam (baseline or subsequent) and definition of positive but do not differ based on imaging schedule (stacked or alternating); suggesting that women and their providers may choose the imaging schedule they prefer.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, University of Vermont, Burlington, VT USA.

ABSTRACT

Purpose: Breast MRI added to mammography increases screening sensitivity for high-risk women but false-positive (FP) rates are higher and the optimal screening schedule for coordination with mammography is unclear. We compare rates of FP MRI when studies were performed on two different schedules.

Patients and methods: High-risk women at the University of Vermont who had at least 1 MRI and 1 mammogram performed within one year between 2004-2012 were eligible for inclusion in this study. Screening was considered stacked if both studies were performed within 90 days and alternating if studies were 4-8 months apart. False positive was defined in one of three ways.

Results: 137 women had screening which met inclusion criteria and 371 MRIs were reviewed. The FP rates were similar for the two schedules when considering BI-RAD 4, 5, 0 or biopsy as a positive test. FP rates were significantly higher for the stacked schedule (18.2 vs. 10.2%, p = 0.026) when considering BI-RADS 3-4-5-0 as positive test, due to the elevated rate of BI-RADS 3 assessments among stacked exams.

Conclusion: False positive rates differ based on the type of exam (baseline or subsequent) and definition of positive but do not differ based on imaging schedule (stacked or alternating); suggesting that women and their providers may choose the imaging schedule they prefer. This is significant as a randomized clinical trial comparing the two schedules is not likely to be performed, given the high cost and large number of women needed for such a study.

No MeSH data available.