MRI may help detect more genetic breast cancer. (Fewer False Negatives Than Mammography).

BOSTON -- False-negative mammograms are more likely to occur in women whose breast cancer is linked to a BRCA gene mutation than in those with sporadic disease, Dr. Madeleine Tilanus-Linthorst reported at a meeting sponsored by the American Association for Cancer Research.

In a study of 68 women with breast cancer, false-negative results were reported for 62% of those with cancer linked to a BRCA 1 or BRCA 2 mutation, compared with 29% in women whose cancer arose spontaneously.

In contrast, breast MRI was found to detect breast cancer early in mutation carriers, while the lesions were still occult at mammography and physical examination, thus facilitating early intervention and a greater likelihood for therapeutic success, she said.

MRI sensitivity was 100%, detecting abnormalities in all 12 cancers in mutation carriers with no palpable mass at screening. When mammography was used, no abnormality was identified in 5 of the 12 cases, said Dr. Tilanus-Linthorst of Erasmus University, Rotterdam, the Netherlands.

These findings give weight to the argument that breast MRI should be considered a standard surveillance technique for the early detection of breast cancer in genetically predisposed women, particularly those under age 50 in whom high breast density may already be a factor contributing to an increased rate of false-negative reports.

The specific histologic features of cancer ...