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Journal of Clinical Oncology, 2008 ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 26, No 15S (May 20 Supplement), 2008: 500
© 2008 American Society of Clinical Oncology
Mammographically occult contralateral breast carcinoma detected by magnetic resonance imaging in the elderly
J. R. Bernard, Jr.,
L. A. Vallow,
E. R. DePeri,
D. G. Feigel,
S. Amar,
S. J. Buskirk and
E. A. Perez
Mayo Clinic, Jacksonville, FL
500
Background: Magnetic resonance imaging (MRI) may be able to detect clinically and mammographically occult contralateral breast carcinoma in 3.1% of newly diagnosed breast cancer patients (Lehman CD, et al. N Engl J Med 2007;356:1295–303). Breast cancer incidence has been shown to have a strong correlation with patient age. The incidence of mammographically occult contralateral breast cancer detected by MRI in women with newly diagnosed breast carcinoma in patients > 70 was assessed at our institution. Methods: Between 7/2003 and 07/2007, 159 women age > 70 with pathologically confirmed, newly diagnosed breast cancer were identified from an IRB approved MRI database. Patients noted to have a synchronous contralateral abnormality identified by MRI, but not evident on mammography or clinical examination, were reviewed. Those patients in which biopsy was recommended and performed were further analyzed to determine the incidence of pathologically diagnosed contralateral carcinoma. Results: The median age at diagnosis was 75 (range = 70–91). Mammographically occult contralateral breast abnormalities were described in 65 (41%). Of those women with a contralateral abnormality, biopsy was performed in 28 (43%). Of the women who underwent a biopsy, 9 (32%) had pathologically confirmed carcinoma, whereas 19 (68%) women had other benign diagnoses. Five patients were found to have invasive carcinoma and 4 patients were diagnosed with ductal carcinoma in situ. The overall incidence of mammographically occult contralateral carcinoma in our elderly patient population was 5.7% (9/159). The sensitivity, specificity, positive predictive value, and negative predictive value of MRI were 100%, 87%, 32%, and 100%, respectively. Conclusions: The Mayo Clinic Jacksonville experience suggests that up to 5.7% of newly diagnosed elderly breast cancer patients may have a clinically and mammographically occult carcinoma detected by MRI. Older age should not be a deterrent to obtaining breast MRI and in fact, because of the higher tendency to have a contralateral carcinoma, should be considered. Further study in the use of MRI for screening in this population is needed for corroboration.
No significant financial relationships to disclose.
Abstract presentation from the 2008 ASCO Annual Meeting
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