Breast Cancer Screening in Women with a Familial or Genetic Predisposition: the role of MRI
Year: 2006
Type: dissertation
Study design: Observational Study
Abstract: Women with a strong family history of breast and/or ovarian cancer combined with young \\nages at diagnosis of affected family members have an increased risk of these types of cancer. \\nIn 1994 and 1995 respectively, the BRCA1 and BRCA2 genes were identified. A germline \\nmutation in one of these genes is associated with very high risks of early onset breast and \\novarian cancer. \\nCurrent options for BRCA1/2 mutation carriers to reduce their risk of breast cancer or death \\nby breast cancer include prophylactic mastectomy, prophylactic salpingo-oophorectomy, \\nchemoprevention and screening. Screening for breast cancer is also offered to women with a \\nfamilial predisposition, but without a proven BRCA1/2 mutation. Several studies have \\ninvestigated the efficacy of mammographic screening, sometimes in combination with clinical \\nbreast examination (CBE)) in high-risk groups of women. However, the efficacy of \\nmammography screening has never been clearly demonstrated. Sensitivity of mammography \\nwas low this group of women in comparison with post-menopausal women screened in \\npopulation based studies, most likely because of the young screening age of and consequently \\nfrequent a high density of the breast tissue. MRI appeared to be a sensitive method for \\ndetection of breast cancer in a diagnostic setting. For this reason, in the late nineties several \\nbreast cancer screening studies comparing the value of MRI and mammography were set up \\nin women with a genetic susceptibility. Results of pilot and preliminary studies showed in all \\nof them a very high sensitivity of MRI, while sensitivity of mammography was never higher \\nthan 50%. Recently, the first results of four large prospective studies were published, among \\nwhich the Dutch national MRISC study. In this thesis, the short-term results of the MRISC \\nstudy are described. Two of the main objectives of the MRISC study are addressed in this \\nthesis: \\n \\n1. Assessment of the efficacy of screening in diagnosing early-stage breast cancer in women \\nwith a familial or genetic predisposition. \\n2. Assessment of the value of MRI in this screening scheme compared to mammography.
Author: Mieke Kriege
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W1650964310