There is no strict indication to systematic MRI screening of the contralateral breast in women with newly diagnosed invasive breast cancer

A metanalysis of 22 studies of MRI screening of the contralateral breast to newly diagnosed invasive breast cancer showed that 131 contralateral cancers were detected only by MRI among 3253 contralateral breasts (4.1%). Suspicious findings at MRI were 9.3%, with a  PPV of 47.9%. 35.1% of cancers were ductal carcinoma in situ and 64.9% were invasive (mean size 9.3 mm , most T1 and node negative). Many of these women underwent contralateral mastectomy. MRI is poorly specific and stage at diagnosis suggest the risk of overdiagnosis and overtreatment. Women should be informed of the uncertain benefit and potential harm, including additional investigations and surgery. There is no strict indication to systematic MRI screening of the contralateral breast to primary breast cancer.

Bibliographic Reference:

Brennan ME et al.: "Magnetic Resonance Imaging Screening of the Contralateral Breast in Women With Newly Diagnosed Breast Cancer: Systematic Review and Meta-Analysis of Incremental Cancer Detection and Impact on Surgical Management", J Clin Oncol. 2009 Oct 5. [Epub ahead of print]

Stefano Ciatto
Valeggio sul Mincio, Verona, Italy