Mammography and MRI for screening women who underwent chest radiation therapy (lymphoma survivors): recommendations for surveillance from the Italian College of Breast Radiologists by SIRM

G. Mariscotti, Paolo Belli, Daniela Bernardi, Beniamino Brancato, Massimo Calabrese, Luca A. Carbonaro, Beatrice Cavallo-Marincola, Francesca Caumo, Paola Clauser, Laura Martinchich, Stefania Montemezzi, Pietro Panizza, Federica Pediconi, Alberto Tagliafico, Rubina M. Trimboli, Chiara Zuiani, Francesco Sardanelli

Research output: Contribution to journalArticle

Abstract

Women who underwent chest radiation therapy (CRT) during pediatric/young-adult age (typically, lymphoma survivors) have an increased breast cancer risk, in particular for high doses. The cumulative incidence from 40 to 45 years of age is 13–20 %, similar to that of BRCA mutation carriers for whom contrast-enhanced magnetic resonance imaging (MRI) is recommended. However, in women who underwent CRT, MRI sensitivity is lower (63–80 %) and that of mammography higher (67–70 %) than those observed in women with hereditary predisposition, due to a higher incidence of ductal carcinoma in situ with microcalcifications and low neoangiogenesis. A sensitivity close to 95 % can be obtained only using mammography as an adjunct to MRI. Considering the available evidence, women who underwent CRT before 30 receiving a cumulative dose ≥10 Gy should be invited after 25 (or, at least, 8 years after CRT) to attend the following program: 1. interview about individual risk profile and potential of breast imaging; 2. annual MRI using the same protocol recommended for women with hereditary predisposition; 3. annual bilateral two-view full-field digital mammography or digital breast tomosynthesis (DBT) with synthetic 2D reconstructions. Mammography and MRI can be performed at once or alternately every 6 months. In the case of MRI or contrast material contraindications, ultrasound will be performed instead of MRI. Reporting using BI-RADS is recommended. At the age for entering population screening, the individual risk profile will be discussed with the woman about opting for only mammography/DBT screening or for continuing the intensive protocol.

Original languageEnglish
Pages (from-to)1-4
Number of pages4
JournalRadiologia Medica
DOIs
Publication statusAccepted/In press - Jul 12 2016

Keywords

  • Breast cancer
  • Lymphoma survivors
  • MRI
  • Screening

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Fingerprint Dive into the research topics of 'Mammography and MRI for screening women who underwent chest radiation therapy (lymphoma survivors): recommendations for surveillance from the Italian College of Breast Radiologists by SIRM'. Together they form a unique fingerprint.

  • Cite this

    Mariscotti, G., Belli, P., Bernardi, D., Brancato, B., Calabrese, M., Carbonaro, L. A., Cavallo-Marincola, B., Caumo, F., Clauser, P., Martinchich, L., Montemezzi, S., Panizza, P., Pediconi, F., Tagliafico, A., Trimboli, R. M., Zuiani, C., & Sardanelli, F. (Accepted/In press). Mammography and MRI for screening women who underwent chest radiation therapy (lymphoma survivors): recommendations for surveillance from the Italian College of Breast Radiologists by SIRM. Radiologia Medica, 1-4. https://doi.org/10.1007/s11547-016-0667-9