Breast cancers detected on MRI screens are most often invasive, study finds

Naveen Ghuman, Johns Hopkins University School of Medicine, Baltimore, MD, and colleagues revealed that these invasive screen-detected cancers are most commonly presented as a mass.

Among 50 MRI screen-detected breast cancers in 47 women, the majority of cancers were invasive (64%). Most patients (91%) presented with stage 0 or 1 disease.

The American Cancer Society recommends annual supplemental breast screening with MRI for women having a greater than 20% lifetime risk for breast cancer. While there exists robust data regarding features of mammographic screen-detected breast cancers, the researchers note limited data regarding MRI-screen-detected cancers.

To fill this literature gap, Dr. Ghuman and the team described the clinical outcomes and imaging appearance of MRI screen-detected breast cancers. It included data from 50 screen-detected breast cancers in 47 women identified between 2016 and 2022.

The study led to the following findings:

• The majority of MRI-screen-detected cancers (64%) were invasive.
• Pathology revealed ductal carcinoma in situ (DCIS) in 36%, invasive ductal carcinoma (IDC) in 52%, invasive lobular carcinoma in 10%, and angiosarcoma in 2%.
• The majority of patients (91%) were stage 0 or 1 at diagnosis and there were no breast cancer-related deaths during the follow-up periods.
• Cancers presented as masses in 50%, non-mass enhancement in 48%, and a focus in 2%.
• DCIS was more likely to present as non-mass enhancement (94.4%), whereas invasive cancers were more likely to present as masses (75%).
• All cancers that were stage 2 at diagnosis were detected either on a baseline exam or more than 4 years after the prior MRI exam.

"The findings show that MRI screen-detected breast cancers were most often invasive cancers," the researchers wrote. "Cancers detected by MRI screening had an excellent prognosis in our study population."

Understanding the most common imaging presentations of MRI-screen-detected cancers may guide the interpretation and diagnostic performance of the exam," they concluded.

Reference:

The study titled, "Clinical and Imaging Features of MRI Screen-Detected Breast Cancer," was published online in Clinical Breast Cancer.

DOI: https://doi.org/10.1016/j.clbc.2023.09.012