MRI reveals the risk of a second breast cancer

Breast cancer is the most diagnosed and the leading cause of cancer-related death in women worldwide. Although advances in treatment and early detection mean that more women are surviving breast cancer, these women face an increased risk of developing a second breast cancer.

Breast tissue is mostly fatty, with areas of fibrous connective tissue and glandular tissue, collectively known as fibroglandular tissue. Women with dense breasts have a higher proportion of fibroglandular tissue and less fatty tissue. This can hide lesions on mammography and is an independent risk factor for breast cancer.

Breast MRI has become the preferred imaging method for women with a history of breast cancer. Previous studies have shown that breast MRI has a higher cancer detection rate than mammography.

“Postoperative surveillance breast MRI is increasingly performed as per the annual recommendation of the American College of Radiology for women with dense breasts or who were diagnosed with breast cancer before the age of 50,” said study lead author Su Hyun Lee, from the Department of Radiology at the Seoul National University Hospital (Korea).

Lee and colleagues studied the relationship between risk of a second cancer and background parenchymal enhancement (BPE) on surveillance breast MRI. BPE refers to the brightness, or enhancement, of background tissue on MRI after administration of a contrast agent. The degree of parenchymal enhancement can vary among and within women. It is believed to be related to changes in the blood supply and permeability of the breast tissue, which is affected by hormonal status. Breast cancer treatment in the form of radiation therapy, chemotherapy, or endocrine therapy can also alter BPE in the treated breast.

BPE on contrast-enhanced breast MRI is a known risk factor for breast cancer. Less is known about the relationship between BPE on surveillance breast MRI and the risk of a second breast cancer.

Women with minimal BPE on surveillance breast MRI may not need to undergo breast MRI

Of the 2,668 women in the study, 109 developed a second breast cancer at a median follow-up of 5.8 years. Mild, moderate, or marked EPB on surveillance breast MRI was independently associated with an increased risk of a future second breast cancer compared with minimal EPB.

“The results suggest that BPS on postoperative breast surveillance MRI may indicate response to breast cancer treatment and may be a predictor of modified risk of a second breast cancer after treatment in women with a personal history of breast cancer. of breast cancer”, broad Lee.

The study results point to a role for BPE measurements in refining screening pathways for women with prior breast cancer, Lee concludes.

“The results of our study may help stratify the risk of a second breast cancer in women with a personal history of breast cancer and establish personalized imaging surveillance strategies in terms of imaging modality and selection of the control interval” , said. “For example, women with minimal ELB on surveillance breast MRI may not need to undergo contrast-enhanced breast MRI every year if there are no other risk factors.”


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