Monday 16 May 2005
New research published online today in The Lancet has found that magnetic resonance imaging (MRI) is almost twice as sensitive as X-ray mammography (XRM) in detecting breast cancer in women at high genetic risk.
The findings are the result of a national study (MARIBS) funded by the Medical Research Council and led by Professor Martin Leach of The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust.
Past research has highlighted that around 2% of breast cancer is due to the recently discovered breast cancer gene mutations BRCA1 and BRCA2. Women with one of these gene mutations come from families where there is a strong family risk of breast cancer, and more than half of them will develop breast cancer by the age of 70.
Annual mammograms are offered to women with these gene mutations to allow early identification and treatment of tumours. However, as women below the age of 50 often have dense breasts, mammography is not always very effective at detecting tumours. The MARIBS study looked at whether MRI would be more helpful in detecting tumours within these groups of women.
The MARIBS study showed that XRM managed to identify only 40% of the tumours in women at high genetic risk, whereas MRI pinpointed 77%. It was found that by combining both XRM and MRI screening methods, 94% of tumours would be detected. MRI screening was shown to be particularly effective for women known to carry the BRCA1 gene mutation, detecting 92% of tumours in women carrying this gene, whereas XRM only detected 23%.
Recruitment for the study took place at 22 radiology and genetic centres throughout the UK. In total 838 women at high risk of breast cancer, based on testing, family history or affected relatives, were enrolled onto the study between August 1997 and May 2004. The women, aged 35 to 49 years, were offered annual MRI and XRM for between two and seven years. The results for each were then compared with their true cancer status, assessed either by pathological examination or by the absence of cancer at the following year’s examination.
Each case where a participant received both an XRM and MRI in the same year was analysed, amounting to a total of 1881 screening years. From this number, 35 cancers were detected in total, 19 were detected by MRI alone, six by XRM alone, eight cancers were detected by both methods, and two weren’t detected by either method.
Professor Leach, of The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, and principal investigator for the trial, said: “This study demonstrates that MRI screening is almost twice as sensitive as traditional X-ray mammography in identifying tumours in women of this age group at high genetic risk. As this study was carried out on a countrywide scale, the results represent a realistic assessment of how effective the method would be if it were implemented as a service.”
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Notes to editors
- The Medical Research Council (MRC) is a national organisation funded by the UK tax-payer. Its business is medical research aimed at improving human health; everyone stands to benefit from the outputs. The research it supports and the scientists it trains meet the needs of the health services, the pharmaceutical and other health-related industries and the academic world. MRC has funded work which has led to some of the most significant discoveries and achievements in medicine in the UK. About half of the MRC’s expenditure of approximately £500 million is invested in its 40 Institutes, Units and Centres. The remaining half goes in the form of grant support and training awards to individuals and teams in universities and medical schools. Web site at: www.mrc.ac.uk.
- Magnetic Resonance Imaging and other imaging techniques have opened windows on our bodies and brains. The science of imaging took a huge leap forward in 1973 when MRC funded scientist, Professor Sir Peter Mansfield, devised a way of harnessing the body’s natural magnetic properties to produce exquisitely detailed images of soft tissues, allowing doctors to diagnose disease without exposing patients to the trauma of exploratory surgery. Sir Peter’s work created one of the most powerful diagnostic tools available to modern medicine. He was awarded the Nobel Prize in 2003.
- The Institute of Cancer Research is a centre of excellence with world leading scientists working on cutting edge projects. It was founded in 1909 to carry out research into the causes of cancer and to develop new strategies for its prevention, diagnosis and treatment. It is an institution with a history of firsts in cancer research such as the discovery of the hereditary breast cancer gene BRCA2 in 1995.
- The Institute is a charity that relies on voluntary income. The Institute is a highly cost-effective major cancer research organisation with over 90p in every £ directly supporting research.
- The Institute, together with the Royal Marsden NHS Foundation Trust, forms Europe’s largest Comprehensive Cancer Centre.
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