Annual Breast Cancer Screening May Not Suffice For BRCA-positive Women

NEW YORK (Reuters Health) - In a new study of BRCA-positive women, almost half of the subjects developed cancer less than a year after having normal findings on screening mammography. This suggests that screening intervals need to be shorter than one year for such women.

The findings, which are reported in the April 12th online issue of Cancer, are based on a study of 13 BRCA mutation carriers who were closely followed at Columbia University in New York between 1995 and 2002.

Three of the subjects did not develop breast cancer, lead author Dr. Ian K. Komenaka and colleagues note. Of the 10 patients who developed cancer, 4 had malignancies that were detected at the time of annual screening and 6 had palpable cancers that were identified between annual screening sessions.

Among the six patients with interval malignancies, the average time between normal mammogram findings and tumor detection was 5.1 months. All of the mammograms showed dense breast tissue. The average tumor size at detection was 1.7 cm.

Focused ultrasound was able to detect the tumor mass in 3 of 4 patients at interval cancer presentation. Ultrasound was not performed in the remaining two patients.

With the exception of two patients with ductal carcinoma in situ, the patients with interval malignancies had invasive breast cancer, the authors note. Moreover, lymph node involvement was noted in three of the six patients.

"These results suggest that strong consideration should be given to screening BRCA-positive women" more often than annually and "to using additional imaging techniques, such as breast ultrasonography and/or breast MRI, as part of this screening process," the researchers conclude.

Source: Cancer 2004;00:000-000. [ Google search on this article ]

MeSH Headings: Breast Neoplasms : Neoplasms : Neoplasms by Site : Genes, BRCA1 : Diseases