Supplemental MRI Screening for Women with Extremely Dense Breast Tissue

Marije F. Bakker; Stephanie V. de Lange; Ruud M. Pijnappel; Ritse M. Mann; Petra H. M. Peeters; Evelyn M. Monninkhof; Marleen J. Emaus; Claudette E. Loo; Robertus H. C. Bisschops; Marc B. I. Lobbes; Matthijn D. F. de Jong; Katya M. Duvivier; Jeroen Veltman; Nico Karssemeijer; Harry J. de Koning; Paul J. van Diest; Willem P. T. M. Mali; Maurice A. A. J. van den Bosch; Wouter B. Veldhuis; Carla H. van Gils; DENSE Trial Study Group

doi:10.1056/NEJMoa1903986

Supplemental MRI Screening for Women with Extremely Dense Breast Tissue

Marije F. Bakker, Stephanie V. de Lange, Ruud M. Pijnappel, Ritse M. Mann, Petra H. M. Peeters, Evelyn M. Monninkhof, Marleen J. Emaus, Claudette E. Loo, Robertus H. C. Bisschops, Marc B. I. Lobbes, Matthijn D. F. de Jong, Katya M. Duvivier, Jeroen Veltman, Nico Karssemeijer, Harry J. de Koning, Paul J. van Diest, Willem P. T. M. Mali, Maurice A. A. J. van den Bosch, Wouter B. Veldhuis, Carla H. van Gils^*DENSE Trial Study Group

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

188 Citations (Web of Science)

Abstract

BACKGROUND

Extremely dense breast tissue is a risk factor for breast cancer and limits the detection of cancer with mammography. Data are needed on the use of supplemental magnetic resonance imaging (MRI) to improve early detection and reduce interval breast cancers in such patients.

METHODS

In this multicenter, randomized, controlled trial in the Netherlands, we assigned 40,373 women between the ages of 50 and 75 years with extremely dense breast tissue and normal results on screening mammography to a group that was invited to undergo supplemental MRI or to a group that received mammography screening only. The groups were assigned in a 1:4 ratio, with 8061 in the MRI-invitation group and 32,312 in the mammography-only group. The primary outcome was the between-group difference in the incidence of interval cancers during a 2-year screening period.

RESULTS

The interval-cancer rate was 2.5 per 1000 screenings in the MRI-invitation group and 5.0 per 1000 screenings in the mammography-only group, for a difference of 2.5 per 1000 screenings (95% confidence interval [CI], 1.0 to 3.7; P

CONCLUSIONS

The use of supplemental MRI screening in women with extremely dense breast tissue and normal results on mammography resulted in the diagnosis of significantly fewer interval cancers than mammography alone during a 2-year screening period.

Original language	English
Pages (from-to)	2091-2102
Number of pages	12
Journal	New England Journal of Medicine
Volume	381
Issue number	22
DOIs	https://doi.org/10.1056/NEJMoa1903986
Publication status	Published - 28 Nov 2019
Event	Clinical Trials in Radiology Session at the European Congress of Radiology - Vienna, Austria Duration: 27 Feb 2019 → 3 Mar 2019

Keywords

CANCER
MAMMOGRAPHY
TRIALS
NONCOMPLIANCE
RISK

Access to Document

10.1056/NEJMoa1903986

Cite this

Bakker, M. F., de Lange, S. V., Pijnappel, R. M., Mann, R. M., Peeters, P. H. M., Monninkhof, E. M., Emaus, M. J., Loo, C. E., Bisschops, R. H. C., Lobbes, M. B. I., de Jong, M. D. F., Duvivier, K. M., Veltman, J., Karssemeijer, N., de Koning, H. J., van Diest, P. J., Mali, W. P. T. M., van den Bosch, M. A. A. J., Veldhuis, W. B., ... DENSE Trial Study Group (2019). Supplemental MRI Screening for Women with Extremely Dense Breast Tissue. New England Journal of Medicine, 381(22), 2091-2102. https://doi.org/10.1056/NEJMoa1903986

@article{c2b63916970846c4b15735f56ac6e831,

title = "Supplemental MRI Screening for Women with Extremely Dense Breast Tissue",

abstract = "BACKGROUNDExtremely dense breast tissue is a risk factor for breast cancer and limits the detection of cancer with mammography. Data are needed on the use of supplemental magnetic resonance imaging (MRI) to improve early detection and reduce interval breast cancers in such patients.METHODSIn this multicenter, randomized, controlled trial in the Netherlands, we assigned 40,373 women between the ages of 50 and 75 years with extremely dense breast tissue and normal results on screening mammography to a group that was invited to undergo supplemental MRI or to a group that received mammography screening only. The groups were assigned in a 1:4 ratio, with 8061 in the MRI-invitation group and 32,312 in the mammography-only group. The primary outcome was the between-group difference in the incidence of interval cancers during a 2-year screening period.RESULTSThe interval-cancer rate was 2.5 per 1000 screenings in the MRI-invitation group and 5.0 per 1000 screenings in the mammography-only group, for a difference of 2.5 per 1000 screenings (95% confidence interval [CI], 1.0 to 3.7; PCONCLUSIONSThe use of supplemental MRI screening in women with extremely dense breast tissue and normal results on mammography resulted in the diagnosis of significantly fewer interval cancers than mammography alone during a 2-year screening period.",

keywords = "CANCER, MAMMOGRAPHY, TRIALS, NONCOMPLIANCE, RISK",

author = "Bakker, {Marije F.} and {de Lange}, {Stephanie V.} and Pijnappel, {Ruud M.} and Mann, {Ritse M.} and Peeters, {Petra H. M.} and Monninkhof, {Evelyn M.} and Emaus, {Marleen J.} and Loo, {Claudette E.} and Bisschops, {Robertus H. C.} and Lobbes, {Marc B. I.} and {de Jong}, {Matthijn D. F.} and Duvivier, {Katya M.} and Jeroen Veltman and Nico Karssemeijer and {de Koning}, {Harry J.} and {van Diest}, {Paul J.} and Mali, {Willem P. T. M.} and {van den Bosch}, {Maurice A. A. J.} and Veldhuis, {Wouter B.} and {van Gils}, {Carla H.} and {DENSE Trial Study Group}",

year = "2019",

month = nov,

day = "28",

doi = "10.1056/NEJMoa1903986",

language = "English",

volume = "381",

pages = "2091--2102",

journal = "New England Journal of Medicine",

issn = "0028-4793",

publisher = "MASSACHUSETTS MEDICAL SOCIETY",

number = "22",

note = "Clinical Trials in Radiology Session at the European Congress of Radiology ; Conference date: 27-02-2019 Through 03-03-2019",

}

Bakker, MF, de Lange, SV, Pijnappel, RM, Mann, RM, Peeters, PHM, Monninkhof, EM, Emaus, MJ, Loo, CE, Bisschops, RHC, Lobbes, MBI, de Jong, MDF, Duvivier, KM, Veltman, J, Karssemeijer, N, de Koning, HJ, van Diest, PJ, Mali, WPTM, van den Bosch, MAAJ, Veldhuis, WB, van Gils, CH & DENSE Trial Study Group 2019, 'Supplemental MRI Screening for Women with Extremely Dense Breast Tissue', New England Journal of Medicine, vol. 381, no. 22, pp. 2091-2102. https://doi.org/10.1056/NEJMoa1903986

TY - JOUR

T1 - Supplemental MRI Screening for Women with Extremely Dense Breast Tissue

AU - Bakker, Marije F.

AU - de Lange, Stephanie V.

AU - Pijnappel, Ruud M.

AU - Mann, Ritse M.

AU - Peeters, Petra H. M.

AU - Monninkhof, Evelyn M.

AU - Emaus, Marleen J.

AU - Loo, Claudette E.

AU - Bisschops, Robertus H. C.

AU - Lobbes, Marc B. I.

AU - de Jong, Matthijn D. F.

AU - Duvivier, Katya M.

AU - Veltman, Jeroen

AU - Karssemeijer, Nico

AU - de Koning, Harry J.

AU - van Diest, Paul J.

AU - Mali, Willem P. T. M.

AU - van den Bosch, Maurice A. A. J.

AU - Veldhuis, Wouter B.

AU - van Gils, Carla H.

AU - DENSE Trial Study Group

PY - 2019/11/28

Y1 - 2019/11/28

N2 - BACKGROUNDExtremely dense breast tissue is a risk factor for breast cancer and limits the detection of cancer with mammography. Data are needed on the use of supplemental magnetic resonance imaging (MRI) to improve early detection and reduce interval breast cancers in such patients.METHODSIn this multicenter, randomized, controlled trial in the Netherlands, we assigned 40,373 women between the ages of 50 and 75 years with extremely dense breast tissue and normal results on screening mammography to a group that was invited to undergo supplemental MRI or to a group that received mammography screening only. The groups were assigned in a 1:4 ratio, with 8061 in the MRI-invitation group and 32,312 in the mammography-only group. The primary outcome was the between-group difference in the incidence of interval cancers during a 2-year screening period.RESULTSThe interval-cancer rate was 2.5 per 1000 screenings in the MRI-invitation group and 5.0 per 1000 screenings in the mammography-only group, for a difference of 2.5 per 1000 screenings (95% confidence interval [CI], 1.0 to 3.7; PCONCLUSIONSThe use of supplemental MRI screening in women with extremely dense breast tissue and normal results on mammography resulted in the diagnosis of significantly fewer interval cancers than mammography alone during a 2-year screening period.

AB - BACKGROUNDExtremely dense breast tissue is a risk factor for breast cancer and limits the detection of cancer with mammography. Data are needed on the use of supplemental magnetic resonance imaging (MRI) to improve early detection and reduce interval breast cancers in such patients.METHODSIn this multicenter, randomized, controlled trial in the Netherlands, we assigned 40,373 women between the ages of 50 and 75 years with extremely dense breast tissue and normal results on screening mammography to a group that was invited to undergo supplemental MRI or to a group that received mammography screening only. The groups were assigned in a 1:4 ratio, with 8061 in the MRI-invitation group and 32,312 in the mammography-only group. The primary outcome was the between-group difference in the incidence of interval cancers during a 2-year screening period.RESULTSThe interval-cancer rate was 2.5 per 1000 screenings in the MRI-invitation group and 5.0 per 1000 screenings in the mammography-only group, for a difference of 2.5 per 1000 screenings (95% confidence interval [CI], 1.0 to 3.7; PCONCLUSIONSThe use of supplemental MRI screening in women with extremely dense breast tissue and normal results on mammography resulted in the diagnosis of significantly fewer interval cancers than mammography alone during a 2-year screening period.

KW - CANCER

KW - MAMMOGRAPHY

KW - TRIALS

KW - NONCOMPLIANCE

KW - RISK

U2 - 10.1056/NEJMoa1903986

DO - 10.1056/NEJMoa1903986

M3 - Article

C2 - 31774954

VL - 381

SP - 2091

EP - 2102

JO - New England Journal of Medicine

JF - New England Journal of Medicine

SN - 0028-4793

IS - 22

T2 - Clinical Trials in Radiology Session at the European Congress of Radiology

Y2 - 27 February 2019 through 3 March 2019

ER -