Mammographic, MRI, and ultrasound characteristics of BRCA1, BRCA2, and other genetically high-risk women enrolled in a prospective multi-institution breast cancer screening trial

Abstract

9588 Background: Small retrospective studies suggest that BRCA1 carriers with breast cancer have higher breast density than women with sporadic breast cancer. Studies are examining the role of mammography, MRI and ultrasound (US) in genetically high risk women, however little data exist on the appearance of the breast by these imaging modalities in this population. Methods: We conducted a multi-institution prospective study of mammography, MRI and US in women ≥ 25 yrs old who were high risk defined as BRCA1 or BRCA2 carriers, or close relative (1st or 2nd degree) of a carrier, or multiple close relatives in same lineage with breast or ovarian cancer. Women were eligible if they were unaffected with cancer or had localized breast cancer but had completed adjuvant chemotherapy and radiation therapy at least 6 months prior to study entry and had a normal breast exam. All 3 imaging modalities were performed within 90 days of each other. Results: A total of 195 women were enrolled in this study over a 6 month period of which 190 were eligible. 171 completed all study exams. This included 41 BRCA1 and 39 BRCA2 carriers. The imaging characteristics are summarized in the table below. The only significant difference noted was in breast density. After controlling for menopausal status, BRCA1 and BRCA2 carriers had fewer women with extremely dense breasts than other high risk women (p=0.03). Conclusion: Our prospective study is the first to report results of the characteristics of multiple imaging modalities in BRCA1 and BRCA2 carriers and other genetically high risk women. Our findings suggest that fewer BRCA1/2 carriers have extremely dense breasts than other genetically high risk women. No other significant differences in imaging characteristics were noted. (Supported by NCI U24 CA78146–01 and UO1 CA74680) No significant financial relationships to disclose.