Résumé
Breast magnetic resonance imaging (MRI) with conventional screening methods improves sensitivity in high-risk patients without benefits on specific survival. We evaluated the characteristics, treatments, and prognostic features of breast cancers diagnosed among
BRCA1/2 mutation carriers either inside or outside screening programs that included MRI.
Two groups of patients diagnosed with a new breast cancer between 2001 and 2007 were compared: group 1, patients included in an intensive screening program; and group 2, patients outside of this program.
Twenty-one patients met inclusion criteria for group 1, and 102 for group 2. Seventy-four percent and 65%, respectively, were
BRCA1 mutation carriers. Tumors in both groups had the same characteristics (pN, grade, estrogen receptor, progesterone receptor, HER2 expression), except for smaller tumor size in group 1 (median, 6 mm vs. 22 mm;
P < .0001). Group 1 patients had more frequent sentinel node procedures (57% vs. 28%;
P = .021) and less commonly received chemotherapy (43% vs. 86%;
P < .0001). The 3-year disease-free survival (93% vs. 74%;
P = .1) and the 3-year overall survival (100% vs. 92%;
P = .2) did not differ between groups.
MRI might provide improvement in
BRCA1/2 carriers in terms of smaller tumor size and treatment morbidity. However, because of aggressive intrinsic characteristics, this does not turn into significant survival benefits.