Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging

Ellen Warner, Kimberley Hill, Petrina Causer, Donald Plewes, Roberta Jong, Martin Yaffe, William D. Foulkes, Parviz Ghadirian, Henry T. Lynch, Fergus Couch, John Wong, Frances Wright, Ping Sun, Steven A. Narod

Research output: Contribution to journalArticle

156 Citations (Scopus)

Abstract

Purpose: The sensitivity of magnetic resonance imaging (MRI) for breast cancer screening exceeds that of mammography. If MRI screening reduces mortality in women with a BRCA1 or BRCA2 mutation, it is expected that the incidence of advanced-stage breast cancers should be reduced in women undergoing MRI screening compared with those undergoing conventional screening. Patients and Methods: We followed 1,275 women with a BRCA1 or BRCA2 mutation for a mean of 3.2 years. In total, 445 women were enrolled in an MRI screening trial in Toronto, Ontario, Canada, and 830 were in the comparison group. The cumulative incidences of ductal carcinoma in situ (DCIS), early-stage, and late-stage breast cancers were estimated at 6 years in the cohorts. Results: There were 41 cases of breast cancer in the MRI-screened cohort (9.2%) and 76 cases in the comparison group (9.2%). The cumulative incidence of DCIS or stage I breast cancer at 6 years was 13.8% (95% CI, 9.1% to 18.5%) in the MRI-screened cohort and 7.2% (95% CI, 4.5% to 9.9%) in the comparison group (P = .01). The cumulative incidence of stages II to IV breast cancers was 1.9% (95% CI, 0.2% to 3.7%) in the MRI-screened cohort and 6.6% (95% CI, 3.8% to 9.3%) in the comparison group (P = .02). The adjusted hazard ratio for the development of stages II to IV breast cancer associated with MRI screening was 0.30 (95% CI, 0.12 to 0.72; P = .008). Conclusion: Annual surveillance with MRI is associated with a significant reduction in the incidence of advanced-stage breast cancer in BRCA1 and BRCA2 carriers.

Original languageEnglish
Pages (from-to)1664-1669
Number of pages6
JournalJournal of Clinical Oncology
Volume29
Issue number13
DOIs
StatePublished - May 1 2011

Fingerprint

Magnetic Resonance Imaging
Prospective Studies
Breast Neoplasms
Mutation
Incidence
Carcinoma, Intraductal, Noninfiltrating
Ontario
Mammography
Early Detection of Cancer
Canada
Mortality

All Science Journal Classification (ASJC) codes

  • Cancer Research
  • Oncology

Cite this

Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging. / Warner, Ellen; Hill, Kimberley; Causer, Petrina; Plewes, Donald; Jong, Roberta; Yaffe, Martin; Foulkes, William D.; Ghadirian, Parviz; Lynch, Henry T.; Couch, Fergus; Wong, John; Wright, Frances; Sun, Ping; Narod, Steven A.

In: Journal of Clinical Oncology, Vol. 29, No. 13, 01.05.2011, p. 1664-1669.

Research output: Contribution to journalArticle

Warner, E, Hill, K, Causer, P, Plewes, D, Jong, R, Yaffe, M, Foulkes, WD, Ghadirian, P, Lynch, HT, Couch, F, Wong, J, Wright, F, Sun, P & Narod, SA 2011, 'Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging', Journal of Clinical Oncology, vol. 29, no. 13, pp. 1664-1669. https://doi.org/10.1200/JCO.2009.27.0835
Warner, Ellen ; Hill, Kimberley ; Causer, Petrina ; Plewes, Donald ; Jong, Roberta ; Yaffe, Martin ; Foulkes, William D. ; Ghadirian, Parviz ; Lynch, Henry T. ; Couch, Fergus ; Wong, John ; Wright, Frances ; Sun, Ping ; Narod, Steven A. / Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging. In: Journal of Clinical Oncology. 2011 ; Vol. 29, No. 13. pp. 1664-1669.
@article{f0632b439ab94ec2b1bd01884820a13f,
title = "Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging",
abstract = "Purpose: The sensitivity of magnetic resonance imaging (MRI) for breast cancer screening exceeds that of mammography. If MRI screening reduces mortality in women with a BRCA1 or BRCA2 mutation, it is expected that the incidence of advanced-stage breast cancers should be reduced in women undergoing MRI screening compared with those undergoing conventional screening. Patients and Methods: We followed 1,275 women with a BRCA1 or BRCA2 mutation for a mean of 3.2 years. In total, 445 women were enrolled in an MRI screening trial in Toronto, Ontario, Canada, and 830 were in the comparison group. The cumulative incidences of ductal carcinoma in situ (DCIS), early-stage, and late-stage breast cancers were estimated at 6 years in the cohorts. Results: There were 41 cases of breast cancer in the MRI-screened cohort (9.2{\%}) and 76 cases in the comparison group (9.2{\%}). The cumulative incidence of DCIS or stage I breast cancer at 6 years was 13.8{\%} (95{\%} CI, 9.1{\%} to 18.5{\%}) in the MRI-screened cohort and 7.2{\%} (95{\%} CI, 4.5{\%} to 9.9{\%}) in the comparison group (P = .01). The cumulative incidence of stages II to IV breast cancers was 1.9{\%} (95{\%} CI, 0.2{\%} to 3.7{\%}) in the MRI-screened cohort and 6.6{\%} (95{\%} CI, 3.8{\%} to 9.3{\%}) in the comparison group (P = .02). The adjusted hazard ratio for the development of stages II to IV breast cancer associated with MRI screening was 0.30 (95{\%} CI, 0.12 to 0.72; P = .008). Conclusion: Annual surveillance with MRI is associated with a significant reduction in the incidence of advanced-stage breast cancer in BRCA1 and BRCA2 carriers.",
author = "Ellen Warner and Kimberley Hill and Petrina Causer and Donald Plewes and Roberta Jong and Martin Yaffe and Foulkes, {William D.} and Parviz Ghadirian and Lynch, {Henry T.} and Fergus Couch and John Wong and Frances Wright and Ping Sun and Narod, {Steven A.}",
year = "2011",
month = "5",
day = "1",
doi = "10.1200/JCO.2009.27.0835",
language = "English",
volume = "29",
pages = "1664--1669",
journal = "Journal of Clinical Oncology",
issn = "0732-183X",
publisher = "American Society of Clinical Oncology",
number = "13",

}

TY - JOUR

T1 - Prospective study of breast cancer incidence in women with a BRCA1 or BRCA2 mutation under surveillance with and without magnetic resonance imaging

AU - Warner, Ellen

AU - Hill, Kimberley

AU - Causer, Petrina

AU - Plewes, Donald

AU - Jong, Roberta

AU - Yaffe, Martin

AU - Foulkes, William D.

AU - Ghadirian, Parviz

AU - Lynch, Henry T.

AU - Couch, Fergus

AU - Wong, John

AU - Wright, Frances

AU - Sun, Ping

AU - Narod, Steven A.

PY - 2011/5/1

Y1 - 2011/5/1

N2 - Purpose: The sensitivity of magnetic resonance imaging (MRI) for breast cancer screening exceeds that of mammography. If MRI screening reduces mortality in women with a BRCA1 or BRCA2 mutation, it is expected that the incidence of advanced-stage breast cancers should be reduced in women undergoing MRI screening compared with those undergoing conventional screening. Patients and Methods: We followed 1,275 women with a BRCA1 or BRCA2 mutation for a mean of 3.2 years. In total, 445 women were enrolled in an MRI screening trial in Toronto, Ontario, Canada, and 830 were in the comparison group. The cumulative incidences of ductal carcinoma in situ (DCIS), early-stage, and late-stage breast cancers were estimated at 6 years in the cohorts. Results: There were 41 cases of breast cancer in the MRI-screened cohort (9.2%) and 76 cases in the comparison group (9.2%). The cumulative incidence of DCIS or stage I breast cancer at 6 years was 13.8% (95% CI, 9.1% to 18.5%) in the MRI-screened cohort and 7.2% (95% CI, 4.5% to 9.9%) in the comparison group (P = .01). The cumulative incidence of stages II to IV breast cancers was 1.9% (95% CI, 0.2% to 3.7%) in the MRI-screened cohort and 6.6% (95% CI, 3.8% to 9.3%) in the comparison group (P = .02). The adjusted hazard ratio for the development of stages II to IV breast cancer associated with MRI screening was 0.30 (95% CI, 0.12 to 0.72; P = .008). Conclusion: Annual surveillance with MRI is associated with a significant reduction in the incidence of advanced-stage breast cancer in BRCA1 and BRCA2 carriers.

AB - Purpose: The sensitivity of magnetic resonance imaging (MRI) for breast cancer screening exceeds that of mammography. If MRI screening reduces mortality in women with a BRCA1 or BRCA2 mutation, it is expected that the incidence of advanced-stage breast cancers should be reduced in women undergoing MRI screening compared with those undergoing conventional screening. Patients and Methods: We followed 1,275 women with a BRCA1 or BRCA2 mutation for a mean of 3.2 years. In total, 445 women were enrolled in an MRI screening trial in Toronto, Ontario, Canada, and 830 were in the comparison group. The cumulative incidences of ductal carcinoma in situ (DCIS), early-stage, and late-stage breast cancers were estimated at 6 years in the cohorts. Results: There were 41 cases of breast cancer in the MRI-screened cohort (9.2%) and 76 cases in the comparison group (9.2%). The cumulative incidence of DCIS or stage I breast cancer at 6 years was 13.8% (95% CI, 9.1% to 18.5%) in the MRI-screened cohort and 7.2% (95% CI, 4.5% to 9.9%) in the comparison group (P = .01). The cumulative incidence of stages II to IV breast cancers was 1.9% (95% CI, 0.2% to 3.7%) in the MRI-screened cohort and 6.6% (95% CI, 3.8% to 9.3%) in the comparison group (P = .02). The adjusted hazard ratio for the development of stages II to IV breast cancer associated with MRI screening was 0.30 (95% CI, 0.12 to 0.72; P = .008). Conclusion: Annual surveillance with MRI is associated with a significant reduction in the incidence of advanced-stage breast cancer in BRCA1 and BRCA2 carriers.

UR - http://www.scopus.com/inward/record.url?scp=79955638821&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79955638821&partnerID=8YFLogxK

U2 - 10.1200/JCO.2009.27.0835

DO - 10.1200/JCO.2009.27.0835

M3 - Article

C2 - 21444874

AN - SCOPUS:79955638821

VL - 29

SP - 1664

EP - 1669

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

IS - 13

ER -