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Even after careful clinical and mammographic evaluation, cancer is found in the contralateral breast in up to 10% of women who have received treatment for unilateral breast cancer. ACRIN 6667 was conducted to determine whether magnetic resonance imaging (MRI) could improve on clinical breast examination and mammography in detecting contralateral breast cancer soon after the initial diagnosis of unilateral breast cancer. METHODS A total of 969 women with a recent diagnosis of unilateral breast cancer and no abnormalities on mammographic and clinical examination of the contralateral breast underwent breast MRI. The diagnosis of MRI-detected cancer was confirmed by means of biopsy within 12 months after study entry. The absence of breast cancer was determined by means of biopsy, the absence of positive findings on repeat imaging and clinical examination, or both at 1 year of follow-up. RESULTS MRI detected clinically and mammographically occult breast cancer in the contralateral breast in 30 of 969 women who were enrolled in the study (3.1%). The sensitivity of MRI in the contralateral breast was 91%, and the specificity was 88%. The negative predictive value of MRI was 99%. A biopsy was performed on the basis of a positive MRI finding in 121 of the 969 women (12.5%), 30 of whom had specimens that were positive for cancer (24.8%); 18 of the 30 specimens were positive for invasive cancer. The mean diameter of the invasive tumors detected was 10.9 mm. The additional number of cancers detected was not influenced by breast density, menopausal status, or the histologic features of the primary tumor. CONCLUSIONS MRI can detect cancer in the contralateral breast that is missed by mammography and clinical examination at the time of the initial breast-cancer diagnosis. (ClinicalTrials.gov number, NCT00058058. opens in new tab.) |
Acknowledgements
This shared data set was provided in collaboration with the American College of Radiology Core Lab. Many thanks are due to the ACRIN 6667 trial team, and all the patients participating in the study. This study was supported by ACRIN, which received funding from the National Cancer Institute through UO1 CA080098, under the American Recovery and Reinvestment ACT of 2009 (ARRA) and UO1 CA079778. (are the numbers in red correct for this collection?)
Please see QIN ECOG-ACRIN Data Sharing page for an overview and list of other ECOG-ACRIN data collections available on TCIA.
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