Site Editor
William J. Gradishar, MD, FACP, FASCO
William J. Gradishar, MD, FACP, FASCO
Posted: Monday, April 1, 2024
Steven A. Narod, MD, of Women’s College Hospital, Toronto, and colleagues conducted a cohort study involving 2,488 women with BRCA1 or BRCA2 sequence variations to examine the impact of MRI surveillance on breast cancer mortality risk. Results showed a significant reduction in breast cancer mortality among women with BRCA1 sequence variations who underwent MRI surveillance compared with those who did not, with mortality rates of 3.2% and 14.9%, respectively, at 20 years. The study spanned from 1995 to 2015, with participants completing baseline and follow-up questionnaires documenting screening histories and vital status. These results were published in JAMA Oncology.
Of the participants (mean age, 41.2 years), 70.6% underwent at least one screening MRI, and 29.4% did not. After a mean follow-up of 9.2 years, 344 women (13.8%) developed breast cancer, and 35 (1.4%) died of breast cancer. For women with BRCA1 sequence variations, the age-adjusted hazard ratio for breast cancer mortality associated with MRI surveillance was significantly lower (hazard ratio [HR] = 0.20, 95% confidence interval [CI] = 0.10–0.43, P < .001). However, for women with BRCA2 sequence variations, the hazard ratio was not statistically significant (HR = 0.87, 95% CI = 0.10–17.25, P = .93).
These findings underscore the potential clinical benefit of MRI surveillance in reducing breast cancer mortality among women with BRCA1 sequence variations. Integrating MRI into surveillance programs for this high-risk population may facilitate early detection and intervention. However, the lack of significant findings for women with BRCA2 sequence variations highlights the need for additional research to clarify MRI surveillance effectiveness in this subgroup. Overall, the study highlights MRI surveillance as a valuable tool in managing breast cancer risk in genetically predisposed populations, particularly those with BRCA1 mutations, according to the investigators.
Disclosure: For full disclosures of the study authors, visit jamanetwork.com.
JNCCN Spotlights
