Screening for hereditary breast cancer.
1Department of Medical Oncology, Sunnybrook Health Sciences Center and University of Toronto, Ontario, Canada.
Seminars in Oncology
|October 9, 2007
Summary
For hereditary breast cancer, contrast-enhanced magnetic resonance imaging (MRI) significantly improves early detection compared to mammography alone. Adding MRI to screening protocols enhances cancer identification in high-risk women.
Area of Science:
- Oncology
- Radiology
- Genetics
Background:
- Hereditary breast cancer risk necessitates effective screening strategies.
- Mammography alone has limited sensitivity in dense breasts common in younger, high-risk women.
- Early tumor detection is crucial for the efficacy of screening over mastectomy.
Purpose of the Study:
- To evaluate the effectiveness of adding contrast-enhanced magnetic resonance imaging (MRI) to mammography for hereditary breast cancer screening.
- To compare the sensitivity and specificity of combined MRI and mammography versus mammography alone.
- To review current screening recommendations for hereditary breast cancer.
Main Methods:
- Analysis of six prospective comparative studies.
- Assessment of screening modalities including mammography, contrast-enhanced MRI, ultrasound, and clinical breast examination.
- Evaluation of cancer detection rates, sensitivity, specificity, and false positive rates.
Main Results:
- Contrast-enhanced MRI combined with mammography demonstrated over 90% sensitivity, more than double that of mammography alone.
- Ultrasound and clinical breast examination detected few additional cancers.
- Higher initial false positive rates with MRI improved with successive screening rounds.
Conclusions:
- Adding screening MRI to mammography significantly enhances the early detection of hereditary breast cancers.
- This combined approach is estimated to be cost-effective, particularly for women with BRCA mutations.
- Further long-term survival data are needed, but current evidence supports MRI's role in earlier cancer staging.
Related Concept Videos
02:46Genetic Screens
Genetic screens are tools used to identify genes and mutations responsible for phenotypes of interest. Genetic screens help identify individuals or a group of people at risk of developing genetic diseases and help them with early intervention, targeted therapy, and reproductive options.
Forward genetic screens
Forward or “classical” genetic screens involve creating random mutations in an organism’s DNA using radiation, mutagens, or insertion of additional bases, which result in visible changes...
Forward genetic screens
Forward or “classical” genetic screens involve creating random mutations in an organism’s DNA using radiation, mutagens, or insertion of additional bases, which result in visible changes...
01:20The Retinoblastoma Gene
Tumor suppressor genes are normal genes that can slow down cell division, repair DNA mistakes, or program the cells for apoptosis in case of irreparable damage. Hence, they play an essential role in preventing the proliferation of damaged cells.
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
01:20The Retinoblastoma Gene
Tumor suppressor genes are normal genes that can slow down cell division, repair DNA mistakes, or program the cells for apoptosis in case of irreparable damage. Hence, they play an essential role in preventing the proliferation of damaged cells.
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
The first-ever tumor suppressor gene called Rb was identified in retinoblastoma - a rare eye tumor in children. In inherited forms of the disease, a child inherits one defective copy of the Rb gene, which predisposes them to retinoblastoma. However,...
02:59Cancer Prevention
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...
02:59Cancer Prevention
Several factors can increase the risk of cancer in an individual. About 50% of cancer cases can be prevented by adopting a healthy lifestyle, regular exercise, eating healthy, and following a modest cancer prevention diet. Epidemiological studies have consistently shown that populations with vegetable and fruit-rich diets have reduced the incidence of cancer. On the other hand, populations who have a diet rich in animal fat, red meat, junk food, or high calories are predisposed to cancer.
Some...
Some...