Survival benefit in women with BRCA1 mutation or familial risk in the MRI screening study (MRISC). Issue 7 (17th April 2015)

• Record Type: Journal Article
• Authors: Saadatmand, Sepideh; Obdeijn, Inge‐Marie; Rutgers, Emiel J.; Oosterwijk, Jan C.; Tollenaar, Rob A.; Woldringh, Gwendolyn H.; Bergers, Elisabeth; Verhoef, Cornelis; Heijnsdijk, Eveline A.; Hooning, Maartje J.; de Koning, Harry J.; Tilanus‐Linthorst, Madeleine M.
• Is Part Of: International journal of cancer. Volume 137:Issue 7(2015:Oct. 01)
• Page Start: 1729
• Page End: 1738
• Publication Date: 2015-04-17
• Subjects: Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.29534
• Languages: English
• ISSNs: 0020-7136

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <p>Adding MRI to annual mammography screening improves early breast cancer detection in women with familial risk or <italic>BRCA1/2</italic> mutation, but breast cancer specific metastasis free survival (MFS) remains unknown. We compared MFS of patients from the largest prospective MRI Screening Study (MRISC) with 1:1 matched controls. Controls, unscreened if<50 years, and screened with biennial mammography if ≥50 years, were matched on risk category (<italic>BRCA1</italic>, <italic>BRCA2</italic>, familial risk), year and age of diagnosis. Of 2, 308 MRISC participants, breast cancer was detected in 93 (97 breast cancers), who received MRI <2 years before breast cancer diagnosis; 33 <italic>BRCA1</italic> mutation carriers, 18 <italic>BRCA2</italic> mutation carriers, and 42 with familial risk. MRISC patients had smaller (87% <italic>vs</italic>. 52% <T2, <italic>p</italic> < 0.001), more often node negative (69% <italic>vs</italic>. 44%, <italic>p</italic> = 0.001) tumors and received less chemotherapy (39% <italic>vs</italic>. 77%, <italic>p</italic> < 0.001) and hormonal therapy (14% <italic>vs</italic>. 47%, <italic>p</italic> < 0.001) than controls. Median follow‐up time was 9 years (range 0–14). Breast cancer metastasized in 9% (8/93) of MRISC patients and in 23% (21/93) of controls (<italic>p</italic> = 0.009). MFS was better in MRISC patients overall (log‐rank <italic>p</italic> = 0.008, HR 0.36, 95% CI 0.16–0.80), with familial risk (log‐rank <italic>p</italic> = 0.024, HR: 0.21, 95% CI 0.04–0.95), and in <italic>BRCA1</italic> mutation carriers (log‐rank <italic>p</italic> = 0.055, HR 0.30, 95% CI 0.08–1.13). MFS remained better in MRISC patients after lead time correction (log‐rank <italic>p</italic> = 0.020, HR 0.40, 95% CI 0.18–0.90). Overall survival was non‐significantly better in MRISC patients (log‐rank <italic>p</italic> = 0.064, HR 0.51, CI 0.24–1.06). Annual screening with MRI and mammography improves metastasis free survival in women with <italic>BRCA1</italic> mutation or familial predisposition.</p> </abstract>