Roberta M Strigel1, Jennifer Rollenhagen2, Elizabeth S Burnside3, Mai Elezaby2, Amy M Fowler4, Frederick Kelcz2, Lonie Salkowski2, Wendy B DeMartini2. 1. Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792; Department of Medical Physics, University of Wisconsin, Madison, Wisconsin; Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin. Electronic address: rstrigel@uwhealth.org. 2. Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792. 3. Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792; Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin. 4. Department of Radiology, University of Wisconsin, 600 Highland Ave, Madison, WI 53792; Department of Medical Physics, University of Wisconsin, Madison, Wisconsin; Carbone Cancer Center, University of Wisconsin, Madison, Wisconsin.
Abstract
RATIONALE AND OBJECTIVES: The BI-RADS Atlas 5th Edition includes screening breast magnetic resonance imaging (MRI) outcome benchmarks. However, the metrics are from expert practices and clinical trials of women with hereditary breast cancer predispositions, and it is unknown if they are appropriate for routine practice. We evaluated screening breast MRI audit outcomes in routine practice across a spectrum of elevated risk patients. MATERIALS AND METHODS: This Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study included all consecutive screening breast MRI examinations from July 1, 2010 to June 30, 2013. Examination indications were categorized as gene mutation carrier (GMC), personal history (PH) breast cancer, family history (FH) breast cancer, chest radiation, and atypia/lobular carcinoma in situ (LCIS). Outcomes were determined by pathology and/or ≥12 months clinical and/or imaging follow-up. We calculated abnormal interpretation rate (AIR), cancer detection rate (CDR), positive predictive value of recommendation for tissue diagnosis (PPV2) and biopsy performed (PPV3), and median size and percentage of node-negative invasive cancers. RESULTS: Eight hundred and sixty examinations were performed in 566 patients with a mean age of 47 years. Indications were 367 of 860 (42.7%) FH, 365 of 860 (42.4%) PH, 106 of 860 (12.3%) GMC, 14 of 860 (1.6%) chest radiation, and 8 of 22 (0.9%) atypia/LCIS. The AIR was 134 of 860 (15.6%). Nineteen cancers were identified (13 invasive, 4 DCIS, two lymph nodes), resulting in CDR of 19 of 860 (22.1 per 1000), PPV2 of 19 of 88 (21.6%), and PPV3 of 19 of 80 (23.8%). Of 13 invasive breast cancers, median size was 10 mm, and 8 of 13 were node negative (61.5%). CONCLUSIONS: Performance outcomes of screening breast MRI in routine clinical practice across a spectrum of elevated risk patients met the American College of Radiology Breast Imaging Reporting and Data System benchmarks, supporting broad application of these metrics. The indication of a personal history of treated breast cancer accounted for a large proportion (42%) of our screening examinations, with breast MRI performance in this population at least comparable to that of other screening indications.
RATIONALE AND OBJECTIVES: The BI-RADS Atlas 5th Edition includes screening breast magnetic resonance imaging (MRI) outcome benchmarks. However, the metrics are from expert practices and clinical trials of women with hereditary breast cancer predispositions, and it is unknown if they are appropriate for routine practice. We evaluated screening breast MRI audit outcomes in routine practice across a spectrum of elevated risk patients. MATERIALS AND METHODS: This Institutional Review Board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study included all consecutive screening breast MRI examinations from July 1, 2010 to June 30, 2013. Examination indications were categorized as gene mutation carrier (GMC), personal history (PH) breast cancer, family history (FH) breast cancer, chest radiation, and atypia/lobular carcinoma in situ (LCIS). Outcomes were determined by pathology and/or ≥12 months clinical and/or imaging follow-up. We calculated abnormal interpretation rate (AIR), cancer detection rate (CDR), positive predictive value of recommendation for tissue diagnosis (PPV2) and biopsy performed (PPV3), and median size and percentage of node-negative invasive cancers. RESULTS: Eight hundred and sixty examinations were performed in 566 patients with a mean age of 47 years. Indications were 367 of 860 (42.7%) FH, 365 of 860 (42.4%) PH, 106 of 860 (12.3%) GMC, 14 of 860 (1.6%) chest radiation, and 8 of 22 (0.9%) atypia/LCIS. The AIR was 134 of 860 (15.6%). Nineteen cancers were identified (13 invasive, 4 DCIS, two lymph nodes), resulting in CDR of 19 of 860 (22.1 per 1000), PPV2 of 19 of 88 (21.6%), and PPV3 of 19 of 80 (23.8%). Of 13 invasive breast cancers, median size was 10 mm, and 8 of 13 were node negative (61.5%). CONCLUSIONS: Performance outcomes of screening breast MRI in routine clinical practice across a spectrum of elevated risk patients met the American College of Radiology Breast Imaging Reporting and Data System benchmarks, supporting broad application of these metrics. The indication of a personal history of treated breast cancer accounted for a large proportion (42%) of our screening examinations, with breast MRI performance in this population at least comparable to that of other screening indications.
Authors: Sima Ehsani; Roberta M Strigel; Erica Pettke; Lee Wilke; Amye J Tevaarwerk; Wendy B DeMartini; Kari B Wisinski Journal: Breast J Date: 2015-03-17 Impact factor: 2.431
Authors: Constance D Lehman; Jeffrey D Blume; Paul Weatherall; David Thickman; Nola Hylton; Ellen Warner; Etta Pisano; Stuart J Schnitt; Constantine Gatsonis; Mitchell Schnall; Gia A DeAngelis; Paul Stomper; Eric L Rosen; Michael O'Loughlin; Steven Harms; David A Bluemke Journal: Cancer Date: 2005-05-01 Impact factor: 6.860
Authors: Bethany L Niell; Sara C Gavenonis; Tina Motazedi; Jessica Cott Chubiz; Elkan P Halpern; Elizabeth A Rafferty; Janie M Lee Journal: J Am Coll Radiol Date: 2014-04-29 Impact factor: 5.532
Authors: M O Leach; C R M Boggis; A K Dixon; D F Easton; R A Eeles; D G R Evans; F J Gilbert; I Griebsch; R J C Hoff; P Kessar; S R Lakhani; S M Moss; A Nerurkar; A R Padhani; L J Pointon; D Thompson; R M L Warren Journal: Lancet Date: 2005 May 21-27 Impact factor: 79.321
Authors: Patricia A Carney; Edward A Sickles; Barbara S Monsees; Lawrence W Bassett; R James Brenner; Stephen A Feig; Robert A Smith; Robert D Rosenberg; T Andrew Bogart; Sally Browning; Jane W Barry; Mary M Kelly; Khai A Tran; Diana L Miglioretti Journal: Radiology Date: 2010-05 Impact factor: 11.105
Authors: Mieke Kriege; Cecile T M Brekelmans; Carla Boetes; Peter E Besnard; Harmine M Zonderland; Inge Marie Obdeijn; Radu A Manoliu; Theo Kok; Hans Peterse; Madeleine M A Tilanus-Linthorst; Sara H Muller; Sybren Meijer; Jan C Oosterwijk; Louk V A M Beex; Rob A E M Tollenaar; Harry J de Koning; Emiel J T Rutgers; Jan G M Klijn Journal: N Engl J Med Date: 2004-07-29 Impact factor: 91.245
Authors: Ellen Warner; Donald B Plewes; Kimberley A Hill; Petrina A Causer; Judit T Zubovits; Roberta A Jong; Margaret R Cutrara; Gerrit DeBoer; Martin J Yaffe; Sandra J Messner; Wendy S Meschino; Cameron A Piron; Steven A Narod Journal: JAMA Date: 2004-09-15 Impact factor: 56.272
Authors: Roberta M Strigel; Elizabeth S Burnside; Mai Elezaby; Amy M Fowler; Frederick Kelcz; Lonie R Salkowski; Wendy B DeMartini Journal: AJR Am J Roentgenol Date: 2017-06 Impact factor: 3.959
Authors: Habib Rahbar; Zheng Zhang; Thomas L Chenevert; Justin Romanoff; Averi E Kitsch; Lucy G Hanna; Sara M Harvey; Linda Moy; Wendy B DeMartini; Basak Dogan; Wei T Yang; Lilian C Wang; Bonnie N Joe; Karen Y Oh; Colleen H Neal; Elizabeth S McDonald; Mitchell D Schnall; Constance D Lehman; Christopher E Comstock; Savannah C Partridge Journal: Clin Cancer Res Date: 2019-01-15 Impact factor: 12.531
Authors: Roberta M Strigel; Erin Bravo; Amye J Tevaarwerk; Bethany M Anderson; Amy L Stella; Heather B Neuman Journal: Clin Breast Cancer Date: 2020-10-17 Impact factor: 3.225
Authors: Jing Luo; Daniel S Hippe; Habib Rahbar; Sana Parsian; Mara H Rendi; Savannah C Partridge Journal: Breast Cancer Res Date: 2019-09-04 Impact factor: 6.466
Authors: Mary W Marsh; Thad S Benefield; Sheila Lee; Michael Pritchard; Katie Earnhardt; Robert Agans; Louise M Henderson Journal: J Womens Health (Larchmt) Date: 2020-09-22 Impact factor: 2.681