Hassan Bukhari, Asim Shaukat, Nosheen Ahmad.
Breast cancer screening; mammography versus dynamic MRI breast.
Professional Med J Jan ;24(1):42-6.

Objectives: To compare the efficacy of Magnetic resonance imaging and Mammography for Breast-Cancer Screening in high risk Women with a Familial or Genetic Predisposition. Study Design: Cross-sectional study. Setting: Department of Radiology Allied Hospital, Faisalabad. Duration: From January 2012 to December 2014, Sample size: 299. Methods: A total of 299 females at high risk of breast cancer were included in this study and they underwent screening rounds of Mammogram and contrast enhanced dynamic breast MRI once a year with independent readings. Both the imaging modalities were interpreted by experience radiologist and all the images were categorized using Breast Imaging Reporting and Data System. In each patient, histopathology results were considered the standard criteria for the calculation of the sensitivity, specificity for both Mammogram and Breast MRI lesions. Results: Mean age of the patients was 46.69±11.86 years. Mammography revealed 11 (3.68%) true positive breast lesions, 22 (7.36%) false positive lesion, 247 (82.61%) true negative and 19 (6.35%) false negative lesions yielding the sensitivity of 36.67% and diagnostic accuracy of 86.3%. Dynamic breast MRI revealed 28 (9.36%) true positive breast lesions with 5 (1.67%) false positive, 264 (88.29%) true negative and 2 (0.67%) false negative lesions yielding sensitivity of 93.3%,specificity of 98.14%,PPV=84.85%,NPV=99.25% and diagnostic accuracy of 97.66%. MRI breast was significantly more sensitive (93.3 vs. 36.67%) and accurate (97.66 vs. 86.3%) than mammography. Conclusion: MRI is more sensitive than mammography in detecting tumors in women with an inherited susceptibility to breast cancer.

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