MRI screening reduces breast cancer deaths due to 3 gene variants

Annual MRI screenings starting at age 30 to 35 may cause three Women with specific genetic changes in their genes have a more than 50 percent reduction in breast cancer mortality

These predictions involve pathogenic variants in the ATM, CHEK2, and PALB2 genes, which are as prevalent as the widely reported BRCA1/2 mutations

"Developing screening guidelines for these women has been difficult because there have been no clinical trials to inform when and how to start screening," said Dr.

This work was a collaboration between the Cancer Intervention and Surveillance Modelling Network (CISNET), the Cancer Predisposition Risk Assessment Consortium (carrier) and the Breast Cancer Surveillance Consortium

Using established breast cancer simulation models, the researchers input age-specific risk estimates provided by CARRIERS and recently published screening outcome data

"For women with pathogenic variants in these genes, our modeling analysis predicted a lifetime risk of breast cancer of 21 to 40 percent, depending on the variant," Lowry said

The simulations compared the combined performance of mammography and MRI with mammography alone and predicted that annual MRI would provide significant additional benefits for these populations

"We also found that starting mammograms before age 40 had no substantial benefit, but increased false-positive screening," Lowry added

Results from the CISNET model informed past guidelines, including the 2009 and 2016 recommendations of the U.

"Modeling is a powerful tool for synthesizing and extending clinical trial and national cohort data to estimate population-level benefits and harms of different cancer control strategies," said Georgetown University Lombardi Comprehensive Cancer Center Professor and senior of the paper Author Dr.

Simulations in the study also predicted the number of false-positive screening results and benign biopsies per 1,000 women who underwent scans, which matched the authors' recommendation for annual MRIs starting earlier

To realize the benefits of cancer screening guidelines based on genetic susceptibility, a woman needs to know that she carries an implicated genetic variant before receiving a diagnosis of the disease

"The value of testing for variants in the genes BRCA1 and BRCA2, the most common breast cancer susceptibility genes, is very well understood

The researchers hope their analysis will help the National Comprehensive Cancer Network (NCCN), the American Cancer Society and other organizations that provide guidance to medical oncologists and radiologists
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Dr.
Allison Kurian, a professor at Stanford University School of Medicine and the paper's senior author, said: "Overall, our recommendation is that for some women with these variants, , slightly earlier than current guidelines recommend screening
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" For example, current NCCN guidelines recommend starting at age 30 for PALB2 patients and 40 years for ATM and CHEK2 patients
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Our results suggest that starting MRIs between the ages of 30 and 35 appears to be beneficial for women with any of these three variants
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Pfizer received clinical trial support and editing services
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No other disclosures were reported
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