Magnetic resonance imaging improves breast screening sensitivity in BRCA mutation carriers age ≥ 50 years : evidence from an individual patient data meta-analysis

X.A. Phi, N. Houssami, I.M. Obdeijn, E. Warner, F. Sardanelli, M.O. Leach, C.C. Riedl, I. Trop, M.M.A. Tilanus-Linthorst, R. Mandel, F. Santoro, G. Kwan-Lim, T.H. Helbich, H.J. Koning, de, E.R. Heuvel, van den, G.H. Bock, de

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Abstract

Purpose There is no consensus on whether magnetic resonance imaging (MRI) should be included in breast screening protocols for women with BRCA1/2 mutations age = 50 years. Therefore, we investigated the evidence on age-related screening accuracy in women with BRCA1/2 mutations using individual patient data (IPD) meta-analysis. Patients and Methods IPD were pooled from six high-risk screening trials including women with BRCA1/2 mutations who had completed at least one screening round with both MRI and mammography. A generalized linear mixed model with repeated measurements and a random effect of studies estimated sensitivity and specificity of MRI, mammography, and the combination in all women and specifically in those age = 50 years. Results Pooled analysis showed that in women age = 50 years, screening sensitivity was not different from that in women age <50 years, whereas screening specificity was. In women age = 50 years, combining MRI and mammography significantly increased screening sensitivity compared with mammography alone (94.1%; 95% CI, 77.7% to 98.7% v 38.1%; 95% CI, 22.4% to 56.7%; P <.001). The combination was not significantly more sensitive than MRI alone (94.1%; 95% CI, 77.7% to 98.7% v 84.4%; 95% CI, 61.8% to 94.8%; P = .28). Combining MRI and mammography in women age = 50 years resulted in sensitivity similar to that in women age <50 years (94.1%; 95% CI, 77.7% to 98.7% v 93.2%; 95% CI, 79.3% to 98%; P = .79). Conclusion Addition of MRI to mammography for screening BRCA1/2 mutation carriers age = 50 years improves screening sensitivity by a magnitude similar to that observed in younger women. Limiting screening MRI in BRCA1/2 carriers age = 50 years should be reconsidered.
Original languageEnglish
Pages (from-to)349-356
JournalJournal of Clinical Oncology
Volume33
Issue number4
DOIs
Publication statusPublished - 2015
Externally publishedYes

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Meta-Analysis
Breast
Magnetic Resonance Imaging
Mammography
Mutation
Linear Models
Sensitivity and Specificity

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Phi, X.A. ; Houssami, N. ; Obdeijn, I.M. ; Warner, E. ; Sardanelli, F. ; Leach, M.O. ; Riedl, C.C. ; Trop, I. ; Tilanus-Linthorst, M.M.A. ; Mandel, R. ; Santoro, F. ; Kwan-Lim, G. ; Helbich, T.H. ; Koning, de, H.J. ; Heuvel, van den, E.R. ; Bock, de, G.H. / Magnetic resonance imaging improves breast screening sensitivity in BRCA mutation carriers age ≥ 50 years : evidence from an individual patient data meta-analysis. In: Journal of Clinical Oncology. 2015 ; Vol. 33, No. 4. pp. 349-356.
@article{99dabaa64cc045b0b3471632498be8ad,
title = "Magnetic resonance imaging improves breast screening sensitivity in BRCA mutation carriers age ≥ 50 years : evidence from an individual patient data meta-analysis",
abstract = "Purpose There is no consensus on whether magnetic resonance imaging (MRI) should be included in breast screening protocols for women with BRCA1/2 mutations age = 50 years. Therefore, we investigated the evidence on age-related screening accuracy in women with BRCA1/2 mutations using individual patient data (IPD) meta-analysis. Patients and Methods IPD were pooled from six high-risk screening trials including women with BRCA1/2 mutations who had completed at least one screening round with both MRI and mammography. A generalized linear mixed model with repeated measurements and a random effect of studies estimated sensitivity and specificity of MRI, mammography, and the combination in all women and specifically in those age = 50 years. Results Pooled analysis showed that in women age = 50 years, screening sensitivity was not different from that in women age <50 years, whereas screening specificity was. In women age = 50 years, combining MRI and mammography significantly increased screening sensitivity compared with mammography alone (94.1{\%}; 95{\%} CI, 77.7{\%} to 98.7{\%} v 38.1{\%}; 95{\%} CI, 22.4{\%} to 56.7{\%}; P <.001). The combination was not significantly more sensitive than MRI alone (94.1{\%}; 95{\%} CI, 77.7{\%} to 98.7{\%} v 84.4{\%}; 95{\%} CI, 61.8{\%} to 94.8{\%}; P = .28). Combining MRI and mammography in women age = 50 years resulted in sensitivity similar to that in women age <50 years (94.1{\%}; 95{\%} CI, 77.7{\%} to 98.7{\%} v 93.2{\%}; 95{\%} CI, 79.3{\%} to 98{\%}; P = .79). Conclusion Addition of MRI to mammography for screening BRCA1/2 mutation carriers age = 50 years improves screening sensitivity by a magnitude similar to that observed in younger women. Limiting screening MRI in BRCA1/2 carriers age = 50 years should be reconsidered.",
author = "X.A. Phi and N. Houssami and I.M. Obdeijn and E. Warner and F. Sardanelli and M.O. Leach and C.C. Riedl and I. Trop and M.M.A. Tilanus-Linthorst and R. Mandel and F. Santoro and G. Kwan-Lim and T.H. Helbich and {Koning, de}, H.J. and {Heuvel, van den}, E.R. and {Bock, de}, G.H.",
year = "2015",
doi = "10.1200/JCO.2014.56.6232",
language = "English",
volume = "33",
pages = "349--356",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "4",

}

Phi, XA, Houssami, N, Obdeijn, IM, Warner, E, Sardanelli, F, Leach, MO, Riedl, CC, Trop, I, Tilanus-Linthorst, MMA, Mandel, R, Santoro, F, Kwan-Lim, G, Helbich, TH, Koning, de, HJ, Heuvel, van den, ER & Bock, de, GH 2015, 'Magnetic resonance imaging improves breast screening sensitivity in BRCA mutation carriers age ≥ 50 years : evidence from an individual patient data meta-analysis', Journal of Clinical Oncology, vol. 33, no. 4, pp. 349-356. https://doi.org/10.1200/JCO.2014.56.6232

Magnetic resonance imaging improves breast screening sensitivity in BRCA mutation carriers age ≥ 50 years : evidence from an individual patient data meta-analysis. / Phi, X.A.; Houssami, N.; Obdeijn, I.M.; Warner, E.; Sardanelli, F.; Leach, M.O.; Riedl, C.C.; Trop, I.; Tilanus-Linthorst, M.M.A.; Mandel, R.; Santoro, F.; Kwan-Lim, G.; Helbich, T.H.; Koning, de, H.J.; Heuvel, van den, E.R.; Bock, de, G.H.

In: Journal of Clinical Oncology, Vol. 33, No. 4, 2015, p. 349-356.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Magnetic resonance imaging improves breast screening sensitivity in BRCA mutation carriers age ≥ 50 years : evidence from an individual patient data meta-analysis

AU - Phi, X.A.

AU - Houssami, N.

AU - Obdeijn, I.M.

AU - Warner, E.

AU - Sardanelli, F.

AU - Leach, M.O.

AU - Riedl, C.C.

AU - Trop, I.

AU - Tilanus-Linthorst, M.M.A.

AU - Mandel, R.

AU - Santoro, F.

AU - Kwan-Lim, G.

AU - Helbich, T.H.

AU - Koning, de, H.J.

AU - Heuvel, van den, E.R.

AU - Bock, de, G.H.

PY - 2015

Y1 - 2015

N2 - Purpose There is no consensus on whether magnetic resonance imaging (MRI) should be included in breast screening protocols for women with BRCA1/2 mutations age = 50 years. Therefore, we investigated the evidence on age-related screening accuracy in women with BRCA1/2 mutations using individual patient data (IPD) meta-analysis. Patients and Methods IPD were pooled from six high-risk screening trials including women with BRCA1/2 mutations who had completed at least one screening round with both MRI and mammography. A generalized linear mixed model with repeated measurements and a random effect of studies estimated sensitivity and specificity of MRI, mammography, and the combination in all women and specifically in those age = 50 years. Results Pooled analysis showed that in women age = 50 years, screening sensitivity was not different from that in women age <50 years, whereas screening specificity was. In women age = 50 years, combining MRI and mammography significantly increased screening sensitivity compared with mammography alone (94.1%; 95% CI, 77.7% to 98.7% v 38.1%; 95% CI, 22.4% to 56.7%; P <.001). The combination was not significantly more sensitive than MRI alone (94.1%; 95% CI, 77.7% to 98.7% v 84.4%; 95% CI, 61.8% to 94.8%; P = .28). Combining MRI and mammography in women age = 50 years resulted in sensitivity similar to that in women age <50 years (94.1%; 95% CI, 77.7% to 98.7% v 93.2%; 95% CI, 79.3% to 98%; P = .79). Conclusion Addition of MRI to mammography for screening BRCA1/2 mutation carriers age = 50 years improves screening sensitivity by a magnitude similar to that observed in younger women. Limiting screening MRI in BRCA1/2 carriers age = 50 years should be reconsidered.

AB - Purpose There is no consensus on whether magnetic resonance imaging (MRI) should be included in breast screening protocols for women with BRCA1/2 mutations age = 50 years. Therefore, we investigated the evidence on age-related screening accuracy in women with BRCA1/2 mutations using individual patient data (IPD) meta-analysis. Patients and Methods IPD were pooled from six high-risk screening trials including women with BRCA1/2 mutations who had completed at least one screening round with both MRI and mammography. A generalized linear mixed model with repeated measurements and a random effect of studies estimated sensitivity and specificity of MRI, mammography, and the combination in all women and specifically in those age = 50 years. Results Pooled analysis showed that in women age = 50 years, screening sensitivity was not different from that in women age <50 years, whereas screening specificity was. In women age = 50 years, combining MRI and mammography significantly increased screening sensitivity compared with mammography alone (94.1%; 95% CI, 77.7% to 98.7% v 38.1%; 95% CI, 22.4% to 56.7%; P <.001). The combination was not significantly more sensitive than MRI alone (94.1%; 95% CI, 77.7% to 98.7% v 84.4%; 95% CI, 61.8% to 94.8%; P = .28). Combining MRI and mammography in women age = 50 years resulted in sensitivity similar to that in women age <50 years (94.1%; 95% CI, 77.7% to 98.7% v 93.2%; 95% CI, 79.3% to 98%; P = .79). Conclusion Addition of MRI to mammography for screening BRCA1/2 mutation carriers age = 50 years improves screening sensitivity by a magnitude similar to that observed in younger women. Limiting screening MRI in BRCA1/2 carriers age = 50 years should be reconsidered.

U2 - 10.1200/JCO.2014.56.6232

DO - 10.1200/JCO.2014.56.6232

M3 - Article

C2 - 25534390

VL - 33

SP - 349

EP - 356

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 4

ER -