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Clinical value of contralateral breast cancers detected by pre-operative MRI in patients diagnosed with DCIS: a population-based cohort study.
Keymeulen, Kristien B I M; Geurts, Sandra M E; Kooreman, Loes F S; Duijm, Lucien E M; Engelen, Sanne; Vanwetswinkel, Sigrid; Luiten, Ernest; Siesling, Sabine; Voogd, Adri C; Tjan-Heijnen, Vivianne C G.
Afiliação
  • Keymeulen KBIM; Department of Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands. K.Keymeulen@mumc.nl.
  • Geurts SME; Division Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht, the Netherlands.
  • Kooreman LFS; Department of Pathology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht, the Netherlands.
  • Duijm LEM; Department of Radiology, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands.
  • Engelen S; Department of Surgery, Maastricht University Medical Centre, P.O. Box 5800, 6202 AZ, Maastricht, the Netherlands.
  • Vanwetswinkel S; Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • Luiten E; Department of Surgery, Tawam Hospital UAE, UAE University, Abu Dhabi, United Arab Emirates.
  • Siesling S; Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.
  • Voogd AC; Department of Epidemiology, Maastricht University Medical Centre, Maastricht, the Netherlands.
  • Tjan-Heijnen VCG; Division Medical Oncology, Maastricht University Medical Centre, GROW, Maastricht University, Maastricht, the Netherlands.
Eur Radiol ; 33(3): 2209-2217, 2023 Mar.
Article em En | MEDLINE | ID: mdl-36180645
OBJECTIVES: For patients with ductal carcinoma in situ (DCIS), data about the impact of breast MRI at primary diagnosis on the incidence and characteristics of contralateral breast cancers are scarce. METHODS: We selected all 8486 women diagnosed with primary DCIS in the Netherlands in 2011-2015 from the Netherlands Cancer Registry. The synchronous and metachronous detection of contralateral DCIS (cDCIS) and contralateral invasive breast cancer (cIBC) was assessed for patients who received an MRI upon diagnosis (MRI group) and for an age-matched control group without MRI. RESULTS: Nineteen percent of patients received an MRI, of which 0.8% was diagnosed with synchronous cDCIS and 1.3% with synchronous cIBC not found by mammography. The 5-year cumulative incidence of synchronous plus metachronous cDCIS was higher for the MRI versus age-matched control group (2.0% versus 0.9%, p = 0.02) and similar for cIBC (3.5% versus 2.3%, p = 0.17). The increased incidence of cDCIS was observed in patients aged < 50 years (sHR = 4.22, 95% CI: 1.19-14.99), but not in patients aged 50-74 years (sHR = 0.89, 95% CI: 0.41-1.93). CONCLUSIONS: MRI at primary DCIS diagnosis detected additional synchronous cDCIS and cIBC, and was associated with a higher rate of metachronous cDCIS without decreasing the rate of metachronous cIBC. This finding was most evident in younger patients. KEY POINTS: • Magnetic resonance imaging at primary diagnosis of ductal carcinoma in situ detected an additional synchronous breast lesion in 2.1% of patients. • In patients aged younger than 50 years, the use of pre-operative MRI was associated with a fourfold increase in the incidence of a second contralateral DCIS without decreasing the incidence of metachronous invasive breast cancers up to 5 years after diagnosis. • In patients aged over 50 years, the use of pre-operative MRI did not result in a difference in the incidence of a second contralateral DCIS or metachronous invasive breast cancer.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Carcinoma Intraductal não Infiltrante Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Female / Humans / Middle aged Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Neoplasias da Mama / Carcinoma Intraductal não Infiltrante Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Female / Humans / Middle aged Idioma: En Ano de publicação: 2023 Tipo de documento: Article