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MRI's high false positive rate has little impact on women's choice of preventive mastectomy
Date:3/25/2008

t, for MRI it was 60 per cent and for the two combined it was 71 per cent. The specificity of the techniques (proportion of true negatives) was 93 per cent for mammography and 90 per cent for MRI or a combination of the two.

The lead author of the study, Dr Nicoline Hoogerbrugge, associate professor and head of the Hereditary Cancer Clinic, said: When we looked at the positive MRI results, we found that 83 per cent of them could not be confirmed histologically and were, therefore, false positives: five out of every six positive MRI scans.

The researchers also found that approximately six per cent of the BRCA mutation carriers who had normal findings from their clinical surveillance, mammograms and MRIs, and who underwent an intended prophylactic mastectomy, had an unsuspected malignancy. One was only four millimetres in size and it is known that MRI and mammograms have difficulty detecting lesions this small, but three were DCIS between six and 15mm. This indicates that further improvement of early breast cancer detection is still necessary, said Dr Hoogerbrugge.

When interviewed during their first surveillance visit, 58 women (30 per cent) expressed a preference for a prophylactic mastectomy. Three had no preference, and the rest preferred to have ongoing surveillance. After some of these women had a positive scan, mastectomy was carried out in 90 per cent of those women who had expressed a preference for it, and in only 31 per cent of those who had preferred surveillance.

Dr Hoogerbrugge said: During the first two years after the establishment of a BRCA mutation, four out of every ten female carriers were confronted with an abnormal MRI or mammography result, but this had a limited impact on their choice for prophylactic mastectomy. The final decision to actually undergo prophylactic mastectomy appeared to be determined more frequently by a womans prior preference than by a positive scan. Significantly more women with a prior pr
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Contact: Emma Mason
wordmason@mac.com
07-711-296-986
European Society for Medical Oncology
Source:Eurekalert

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