Early MRI Screening May Reduce Breast Cancer Mortality Among HL Survivors

Early MRI-based screening may reduce breast cancer mortality among women treated with radiation therapy for Hodgkin lymphoma.
Early MRI-based screening may reduce breast cancer mortality among women treated with radiation therapy for Hodgkin lymphoma.

Early MRI-based screening may reduce breast cancer mortality among women treated with radiation therapy for Hodgkin lymphoma during adolescence, a study published in the Journal of the National Cancer Institute has shown.1

Although female survivors treated with thoracic radiation therapy for childhood cancer have an increased risk for developing breast cancer, there are limited data on the impact of early breast cancer screening among such survivors.

For the study, researchers developed a mathematical model of breast cancer development in order to evaluate the benefit of early-initiated screening of female survivors of adolescent Hodgkin lymphoma. Researchers compared the impact of initiating screening at age 25 years compared with at age 40 years.

Results showed that for Hodgkin lymphoma survivors treated with radiation therapy at age 15 years, the risk of breast cancer mortality by age 75 years was estimated to decrease from 16.65% with no screening to 16.28% with annual mammography, 15.40% with an annual MRI, 15.38% with same-day annual mammography and MRI, and 15.37% with alternating mammography and MRI every 6 months.

Researchers found that an estimated 80 patients would need to be referred for MRI-based screening to prevent 1 death as a result of breast cancer.

However, the study also demonstrated that combinations of MRI and mammography could produce nearly 100 false positives per 1000 screenings performed between ages 25 years and 39 years.

The findings suggest that MRI-based screening should reduce breast cancer mortality in this patient population, but this screening approach can produce a substantial rate of false-positive results, potentially leading to unnecessary treatment.

REFERENCE

1. Hodgson DC, Cotton C, Crystal P, Nathan PC. Impact of early breast cancer screening on mortality among young survivors of childhood Hodgkin's lymphoma [published online ahead of print March 1, 2016]. J Natl Cancer Inst. doi:10.1093/jnci/djw010.
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