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Differences between screen-detected and interval breast cancers among BRCA mutation carriers.
Melissa Pilewskie1, Emily C Zabor2, Elizabeth Gilbert3
1Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, 300 East 66th Street, New York, NY, 10065, USA. pilewskm@mskcc.org.
Breast Cancer Research and Treatment
|January 24, 2019
Summary
Interval breast cancers in BRCA mutation carriers present more aggressive features than screen-detected cancers. Combined mammogram and MRI screening reduces interval cancer development in this high-risk group.
Area of Science:
- Oncology
- Radiology
- Genetics
Background:
- BRCA mutation carriers face elevated breast cancer risk, including interval cancers.
- Understanding differences between screen-detected and interval cancers is crucial for high-risk populations.
Purpose of the Study:
- To compare clinicopathologic features of screen-detected versus interval breast cancers in BRCA mutation carriers.
- To evaluate the impact of screening modalities on interval cancer development.
Main Methods:
- Retrospective review of BRCA mutation carriers diagnosed with breast cancer.
- Comparison of clinical, pathological, and imaging factors for screen-detected vs. interval cancers.
- Analysis of screening methods (mammogram, MRI) in relation to interval cancer occurrence.
Main Results:
- Interval cancers were associated with younger age, lower BMI, and higher likelihood of being Black.
- Interval cancers were more aggressive: larger, node-positive, and requiring more intensive treatment.
- Combined mammogram and MRI screening significantly reduced interval cancer rates compared to single-modality screening.
Conclusions:
- Interval breast cancers in BRCA carriers exhibit poorer prognostic features and necessitate aggressive management.
- Utilizing both mammography and MRI for screening is recommended to minimize interval cancer development in BRCA carriers.
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