Relationship between Background Parenchymal Enhancement on High-risk Screening MRI and Future Breast Cancer Risk

Publication date: January 2019

Source: Academic Radiology, Volume 26, Issue 1

Author(s): Lars J. Grimm, Ashirbani Saha, Sujata V. Ghate, Connie Kim, Mary Scott Soo, Sora C. Yoon, Maciej A. Mazurowski

Rationale and Objectives

To determine if background parenchymal enhancement (BPE) on screening breast magnetic resonance imaging (MRI) in high-risk women correlates with future cancer.

Materials and Methods

All screening breast MRIs (n = 1039) in high-risk women at our institution from August 1, 2004, to July 30, 2013, were identified. Sixty-one patients who subsequently developed breast cancer were matched 1:2 by age and high-risk indication with patients who did not develop breast cancer (n = 122). Five fellowship-trained breast radiologists independently recorded the BPE. The median reader BPE for each case was calculated and compared between the cancer and control cohorts.

Results

Cancer cohort patients were high-risk because of a history of radiation therapy (10%, 6 of 61), high-risk lesion (18%, 11 of 61), or breast cancer (30%, 18 of 61); BRCA mutation (18%, 11 of 61); or family history (25%, 15 of 61). Subsequent malignancies were invasive ductal carcinoma (64%, 39 of 61), ductal carcinoma in situ (30%, 18 of 61) and invasive lobular carcinoma (7%, 4of 61). BPE was significantly higher in the cancer cohort than in the control cohort (P = 0.01). Women with mild, moderate, or marked BPE were 2.5 times more likely to develop breast cancer than women with minimal BPE (odds ratio = 2.5, 95% confidence interval: 1.3–4.8, P = .005). There was fair interreader agreement (κ = 0.39).

Conclusions

High-risk women with greater than minimal BPE at screening MRI have increased risk of future breast cancer.

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