The paradox of MRI for breast cancer screening: high-risk and dense breasts—available evidence and current practice

Insights into Imaging

Table 1 Prospective comparative studies on MRI—including screening of asymptomatic women with hereditary predisposition to breast cancer

1^st author year [Ref], study name (if any), country	Enrollment (cumulative lifetime risk)	Women analysed	Rounds	Breast cancers detected		Mammography		US		Mammography + US		MRI
1^st author year [Ref], study name (if any), country	Enrollment (cumulative lifetime risk)	Women analysed	Rounds	All (Invasive + DCIS)	Invasive/all	Sens (%)	Spec (%)	Sens (%)	Spec (%)	Sens (%)	Spec (%)	Sens (%)	Spec (%)
Kuhl 2000 [58], Kuhl 2005 [59], Germany	Fam, Mut (≥ 20%)	529	1542	43	34/43 (79%)	33	97	40	91	49	89	91	97
Podo 2002 [60], Sardanelli 2007 [61], Sardanelli 2011 [62]	Fam, Mut (> 30%)	501	1592	52	44/52 (85%)	50	99	52	98	63	98	91	97
Kriege 2004 [63], Rijnsburger 2010 [64]	Fam, Mut (≥ 15%)	2157	8760	97	78/97 (80%)	41	95	NR	NR	NR	NR	71	90
Warner 2004 [65], Canada	Mut (estimated > 40%)	236	457	22	16/22 (73%)	36	100	33	96	NR	NR	77	95
Leach 2005 [66], MARIBS, UK	Fam, Mut (estimated ≥ 30%)	649	1881	35	29/35 (83%)	40	93	NR	NR	NR	NR	77	81
Lehman 2005 [67], USA	Fam, Mut (> 25%)	367	367	4	3/4 (75%)	25	99	NR	NR	NR	NR	100	94
Hagen 2007 [68], Norway	Mut (estimated > 40%)	491	867	25	21/25 (84%)	57^b	NR	NR	NR	NR	NR	86^b	NR
Riedl 2007 [69], Riedl 2015 [70], Austria	Fam, Mut (> 20%)	559	1365	40	26/4 (65%)	38	97	38	97	50	96	90	89
Kuhl 2010 [71], EVA Trial, Germany	Fam, Mut (≥ 20%)	687	1679	27	16/27 (59%)	33	99	37	98	48	98	93	98
Trop 2010 [72], Canada	Fam, Mut (> 0%)	184	387	12	9/12 (75%)	58	96	42	94^b	67	91^b	83	94
Total/range	Fam, Mut; or Mut (≥ 15%–> 40%)	6360	18,897	357	276/357 (77%)	25–58	93–100	33–52	91–98	48–67	89–98	71–100	81–98

Studies from 2000 to 2015 are listed in order of publication; in case of more than one report (e.g. preliminary, mid-term, final results), the final results are reported
MRI magnetic resonance imaging, DCIS ductal carcinoma in situ, Fam women enrolled for being at elevated familial risk of breast cancer, Mut women enrolled for being proven carriers of deleterious mutation in a breast cancer susceptibility gene, NR not reported, Sens sensitivity, Spec specificity, US ultrasound
^aSensitivities at the time of diagnosis for patients who underwent both mammography and MRI
^bBiannual (instead of annual) US plus clinical breast examination session