Abbreviated MRI outperforms 3-D mammograms at finding cancer in dense breasts

In Clinical Studies News by Barbara Jacoby

By: ECOG-ACRIN Cancer Research Group


According to a study published today in the Journal of the American Medical Association, abbreviated breast magnetic resonance imaging (MRI) detected significantly more cancers than digital breast tomosynthesis (3-D mammography) in average-risk women with dense breast tissue. The study compared the 10-minute MRI exam to 3-D mammography, in women with dense breasts, because the ability of mammography to detect breast cancer is limited in these women. The ECOG-ACRIN Cancer Research Group (ECOG-ACRIN) designed and conducted the study (EA1141) with funding from the National Cancer Institute, part of the National Institutes of Health, and Bracco Diagnostics Inc. (Monroe Township, NJ).

According to Christopher E. Comstock, MD, the publication’s lead author, “When screening women at average risk with dense breasts, we found that abbreviated breast MRI detected significantly more (almost two and a half times as many) breast cancers as 3-D mammography. We also found that the abbreviated breast MRI was well tolerated by women, with very few side effects.”

Dr. Comstock is Attending Radiologist and Director of Breast Imaging Clinical Trials at Memorial Sloan Kettering Cancer Center and Imaging Chair for ECOG-ACRIN’s Breast Cancer Committee. Study leadership included researchers from Memorial Sloan Kettering Cancer Center, University Hospital of RWTH Aachen, University of Chicago, University of Pennsylvania and the Department of Biostatistics and Center for Statistical Sciences at Brown University School of Public Health.

Despite current screening methods, over 40,000 women die each year from breast . The ability of mammography to detect breast cancer is especially limited in women with dense breast tissue. Having dense breasts is not an abnormal condition; in fact, about half of all women over the age of 40 have dense breasts.

Breast MRI is a screening test that uses radio waves to capture images following intravenous injection of contrast dye. Because it is not limited by breast density, MRI offers the highest cancer detection rate of all breast imaging modalities. However, breast MRI is more expensive than a mammogram, takes longer to perform (45 minutes compared to about 15 minutes for a mammogram) and requires an injection.

Although most evidence exists for using MRI to screen the small proportion of women at very high risk of breast cancer, there is accumulating evidence, pioneered by Christiane K. Kuhl, MD, Ph.D. (Chairman of Radiology at University Hospital Aachen and the publication’s senior author), that the higher sensitivity of MRI is also seen in women at average risk.

As Dr. Comstock explained, “Although MRI is undoubtedly the most sensitive test for detecting breast cancer, it is not being used to screen the large number of average-risk women with dense breasts due to its high cost and time to perform. Abbreviated breast MRI is a 10-minute test that reduces the complexity and cost of MRI by shortening the time it takes to perform and interpret the exam. The EA1141 results will hopefully give far more women access to this powerful tool in the fight against breast cancer.