Paradigmenwechsel in der Mammadiagnostik im Zeitalter der Mamma-MRT

Zusammenfassung

Die kontrastmittelgestützte Mamma-MRT ist unbestritten allen anderen bildgebenden Verfahren in der Früherkennung des Mammakarzinoms überlegen. Dies gilt sowohl für intraduktale, als auch für invasive Tumorstadien. Dessen ungeachtet sind in den nationalen und internationalen Empfehlungen weiterhin die Röntgenmammografie und ergänzend die Mammasonografie als führende Untersuchungsverfahren etabliert. Mit Blick auf die überzeugenden Studienergebnisse der letzten Jahre ist es daher an der Zeit, den Stellenwert der Mamma-MRT innerhalb der Brustdiagnostik innerhalb diagnostischer und therapeutischer Strategien zu überdenken und gegebenenfalls zu erneuern.

Abstract

Contrast-enhanced MRI of the breast is well known to be superior to all other imaging modalities in the early diagnostics of breast cancer of both, intraductal and invasive carcinomas. In spite of this, national and international guidelines still recommend the performance of mammography and additional breast ultrasound in the first line diagnostics. Considering the overwhelming evidence gained from the results of studies performed in recent years, it is now time to re-assess the value of breast-MRI in diagnostic and therapeutic strategies.

Schlüsselwörter

Mamma-MRT - Mammakarzinom/Brustkrebs - Bildgebung - Mammografie

Key words

MRI of the breast - breast cancer - breast imaging - mammography

• Literatur

• 1 Kuhl CK, Weigel S, Schrading S et al. Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J Clin Oncol 2010; 28: 1450-1457
• 2 American College of Radiology (ACR). Breast Magnetic Resonance Imaging (MRI) Accreditation Program Requirements; 2012. http://www.acr.org/~/media/ACR/Documents/Accreditation/BreastMRI/Requirements.pdf (letzter Zugriff 18.08.2015)
• 3 Arbeitsgemeinschaft für individuelle Mammadiagnostik (AIM). http://www.aim-mamma.de (letzter Zugriff 18.08.2015)
• 4 Stat Bite Age-Adjusted SEER. Breast cancer incidence rates all ages, all races, female (2000–2009). J Natl Cancer Inst 2013; 105: 512
• 5 Leitlinienprogramm Onkologie der AWMF, Deutschen Krebsgesellschaft e. V. und Deutschen Krebshilfe e. V.. Interdisziplinäre S3-Leitlinie für die Diagnostik, Therapie und Nachsorge des Mammakarzinoms. Germering: W. Zuckschwerdt Verlag; 2012
• 6 Sardanelli F, Podo F, Santoro F et al. Multicenter surveillance of women at high genetic breast cancer risk using mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (the high breast cancer risk italian 1 study): final results. High Breast Cancer Risk Italian 1 (HIBCRIT-1) Study. Invest Radiol 2011; 46: 94-105
• 7 Kolb T, Lichy J, Newhouse J. Comparison of the performance of screening mammography, physical examination, and breast US, and evaluation of factors that influence them: an analysis of 27, 825 patient evaluations. Radiology 2002; 225: 165-175
• 8 Nothacker M, Lelgemann M, Giersiepen K, Weinbrenner S. Evidenzbericht 2007 zur S3-Leitlinie Brustkrebsfrüherkennung in Deutschland, Version 1.00. Band 31. Berlin: Ärztliches Zentrum für Qualität in der Medizin (ÄZQ); 2007. http://www.awmf-leitlinien.de (letzter Zugriff 18.08.2015)
• 9 Boyd NF, Guo H, Martin LJ et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med 2007; 356: 227-236
• 10 Wei J, Chan HP, Wu T et al. Association of computerized mammographic parenchymal pattern measure with breast cancer risk: a pilot case-control study1. Radiology 2011; 260: 42-49
• 11 Martin LJ, Melnichouk O, Guo H et al. Family history, mammographic density, and risk of breast cancer. Cancer Epidemiol Biomarkers Prev 2010; 19: 456-463
• 12 Varghese JS, Thompson DJ, Michailidou K et al. Mammographic breast density and breast cancer: evidence of a share. Cancer Res 2012; 72: 1478-1484
• 13 Berg WA, Gutierrez L, NessAiver MS et al. Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology 2004; 233: 830-849
• 14 Berg WA, Zhang Z, Lehrer D et al. Detection of breast cancer with addition of annual screening ultrasound or a single screening MRI to mammography in women with elevated breast cancer risk. J Am Med Assoc 2012; 307: 1394-1404
• 15 Pisano ED, Hendrick RE, Yaffe MJ et al. Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST. Radiology 2008; 246: 376-383
• 16 Kuhl CK, Schrading S, Bieling HB et al. MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet 2007; 370: 485-492
• 17 Lorenzo M, Zuiani C, Linda A et al. Magnetic resonance imaging in patients with nipple discharge: should we recommend it?. Eur Radiol 2011; 21: 899-907
• 18 Fischer U, Kopka L, Grabbe E. Invasive mucinous carcinoma of the breast missed by contrast-enhancing MR imaging of the breast. Eur Radiol 1996; 6: 929-931
• 19 Kettritz U, Rotter K, Schreer I et al. Stereotactic vacuum-assisted breast biopsy in 2874 patients. A multicenter study. Cancer 2004; 2: 245-251
• 20 Fischer U, Zachariae O, Baum F et al. The influence of preoperative MRI of the breasts on recurrence rate in patients wit breast cancer. Eur Radiol 2004; 14: 1725-1731
• 21 Fischer U, Korthauer A, Baum F et al. Short first-pass MRI of the breast. Acta Radiol 2012; 53: 267-269