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MRI Finds Breast Tumors Early In Hodgkin’s Survivors

May 28, 2014
Written by: , Filed in: Abdominal Imaging, Breast Imaging, Chest Radiology
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MRI use substantially improves breast cancer screening for female survivors of childhood Hodgkin’s lymphoma (HL), according to a Canadian-led study detailed in an article published online today in Cancer.

Women who underwent chest radiation therapy for Hodgkin’s lymphoma have an increased risk of breast cancer. Established guidelines recommend MRI breast screening starting at age 25 or eight years after the chest radiation, whichever is later, said David Hodgson, MD, principal investigator for the study.

Dr Hodgson, a radiation oncologist at Princess Margaret Cancer Centre in Toronto, said that despite the guidelines, most of the vulnerable population does not go for screening:

Female survivors of childhood HL who had chest radiation should speak with their family doctor about after-care assessment and breast cancer screening. We estimate that 75 percent of women who are at high risk because of prior radiotherapy to the chest are not being screened.

Dr. Hodgson was quoted in a news release from the University Health Network of Toronto, which owns Princess Margaret.

His team, collaborating with colleagues at the Dana-Farber Cancer Institute in Boston, evaluated the results of both MRI and mammographic breast cancer screening for 96 female survivors of childhood Hodgkin’s lymphoma who had received chest radiotherapy. The screening detected 10 breast cancers in nine of the women.

Respective sensitivity and specificity were 80 percent and 93.5 percent for MRI alone, 70 percent and 95 percent for mammography alone, and 100 percent and 88.6 percent for the two modalities combined. The patient age at detection ranged from 24 to 43. “This illustrates the young age at which these cancers can occur,” Dr. Hodgson said. “For some of these women, if they had been screened starting at 40 or 50 like average-risk women, it would have been too late.”

MRI, because of its sensitivity to small changes in breast tissue, does have a high rate of false positives. “It’s important to forewarn at-risk HL survivors,” Dr. Hodgson said, “because callbacks definitely heighten anxiety.”

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Minnesota becomes the 16th state to require physicians to inform women if screening reveals they have dense breasts. For details, see our Facebook page.

Related CME seminar (up to 28.75 AMA PRA Category 1 credits™): Thoracic Imaging ($200 early-order discount ends Saturday)

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