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Breast MRI after Cancer Can Lead to Superfluous Biopsies

By MedImaging International staff writers
Posted on 10 Jun 2019

Image: A mammography scan (A) compared to breast MRI (B) (Photo courtesy of MedUni).

A new study claims that for women with a personal history of breast cancer, surveillance breast MRI results in higher biopsy and cancer detection rates.

Researchers at the Kaiser Permanente Washington Health Research Institute (KPWHRI; Seattle, USA), the University of California Davis (UCD; USA), the University of North Carolina (UNC; Chapel Hill, USA), and other institutions conducted a prospective observational study comparing performance of surveillance mammography and breast MRI. The study included 13,266 women (mean age 60 years) with stage 0–3 breast cancer who underwent 33,938 mammographic and 2,506 breast MRI examinations from 2005 to 2012 in the Breast Cancer Surveillance Consortium.

The women were categorized into two groups: mammography alone (11,745 women) or breast MRI (1,521 women). Performance measures were calculated by using end-of-day assessment and occurrence of second breast cancer events within one year of imaging. The researchers compared performance for breast MRI versus mammography alone, adjusting for women, examination, and primary breast cancer characteristics. Analysis was conducted on a per-examination basis.

The results revealed that breast MRI was associated with younger age at diagnosis, chemotherapy, and higher education and income. For women with a personal history of breast cancer, surveillance breast MRI in resulted in almost double the biopsy rates, and 1.7 times detection rates of second breast cancer events, compared with mammography alone. Breast MRI and mammography also showed the same sensitivity for breast cancer detection and interval cancer rates, indicating that mammography did not miss more cancers that would become clinically detectable during a one-year screening interval. The study was published on June 4, 2019, in Radiology.

“After women complete treatment for breast cancer, guidelines recommend annual mammography to screen for second breast cancers. In practice, breast MRI is also being used to screen a growing number of women who have had breast cancer; but more testing isn't always better,” said lead author Karen Wernli, PhD, of KPWHRI. “Women who had more education and income were also more likely to receive breast MRI; not specifically because they had higher risk of second cancers, but because they likely had more access to resources.”

“Some women may feel reassured when they have a biopsy that shows no cancer, while others want to avoid unnecessary biopsies,” said study co-author Dianne Johnson, who is a breast cancer survivor. “As someone who has had breast cancer and has listened to many other women across the country as part of this study, having to get another biopsy after already being treated for cancer raises women's anxiety and distress until they have the result. But most will endure the stress to be sure about whether the finding is cancer.”

While breast MRI provides a very high sensitivity and negative predictive value, particularly in non-calcified breast lesions, problem-solving definitions are not well defined, and the empirical evidence about specific indications, such as architectural distortions, is sparse.

Related Links:
Kaiser Permanente Washington Health Research Institute
University of California Davis
University of North Carolina

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69 (216.96090698242): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=212 ORDER BY `ordering`

70 (354.05158996582): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778256 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (371.93298339844): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778256 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (187.87384033203): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (64.849853515625): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (49.114227294922): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (23.841857910156): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.226043701172): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (56.982040405273): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778256 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (30.994415283203): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778256 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (56.028366088867): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (82.015991210938): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (45.061111450195): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (42.915344238281): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (47.922134399414): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (43.869018554688): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (37.193298339844): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (38.862228393555): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

105 (118.01719665527): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

106 (77.009201049805): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778256 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (71.048736572266): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778256 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (102.04315185547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

109 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

110 (76.055526733398): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294778256 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (640.869140625): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294778256 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (601.05323791504): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (332.83233642578): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (75.101852416992): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

115 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

116 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

117 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

118 (74.148178100586): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

119 (52.928924560547): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

120 (298.97689819336): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 18005.847930908): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (113.01040649414): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

123 (46.014785766602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

124 (471.11511230469): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778256 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778256 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 468552.11257935): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (91.075897216797): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (392.91381835938): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (75.817108154297): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (310.18257141113): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (60.081481933594): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (288.00964355469): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (68.902969360352): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (359.05838012695): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (298.02322387695): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (137.8059387207): SELECT name FROM jos_deeppockets WHERE id=212

136 (55.074691772461): SELECT name FROM jos_deeppockets WHERE id=212

137 (575.06561279297): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (581.02607727051): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))212((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (84.877014160156): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

140 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

141 (!!!!! 10431.051254272): TRUNCATE TABLE jos_trademed_module

142 (119.92454528809): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778256 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (77.962875366211): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294778256 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (609.8747253418): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

147 (69.856643676758): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

148 (!!!!! 1637.9356384277): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (94.890594482422): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

150 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

151 (66.995620727539): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294778256 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294778256 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (50.067901611328): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

153 (46.014785766602): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=212 or channel_id is null)

154 (57.93571472168): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (83.92333984375): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

156 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294778256 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294778256 AND published='1' LIMIT 1

157 (167.1314239502): select jos_twitters.link from jos_twitters where cat=10

158 (42.915344238281): select jos_facebook.link from jos_facebook where cat=10

159 (34.093856811523): select jos_google_plus.link from jos_google_plus where cat=10

160 (31.948089599609): select jos_linkedin.link from jos_linkedin where cat=10

161 (462.05520629883): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1273.8704681396): insert into jos_banners_delta values (14615,'2025-05-02 11:14:48','18.221.79.24','view'),(14202,'2025-05-02 11:14:48','18.221.79.24','view'),(14203,'2025-05-02 11:14:48','18.221.79.24','view')

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