Survival benefit in women with BRCA1 mutation or familial risk in the MRI screening study (MRISC)
Open accessAbstract
Adding MRI to annual mammography screening improves early breast cancer detection in women with familial risk or BRCA1/2 mutation, but breast cancer specific metastasis free survival (MFS) remains unknown. We compared MFS of patients from the largest prospective MRI Screening Study (MRISC) with 1:1 matched controls. Controls, unscreened if<50 years, and screened with biennial mammography if ≥50 years, were matched on risk category (BRCA1, BRCA2, familial risk), year and age of diagnosis. Of 2,308 MRISC participants, breast cancer was detected in 93 (97 breast cancers), who received MRI <2 years before breast cancer diagnosis; 33 BRCA1 mutation carriers, 18 BRCA2 mutation carriers, and 42 with familial risk. MRISC patients had smaller (87% vs. 52% <T2, p < 0.001), more often node negative (69% vs. 44%, p = 0.001) tumors and received less chemotherapy (39% vs. 77%, p < 0.001) and hormonal therapy (14% vs. 47%, p < 0.001) than controls. Median follow‐up time was 9 years (range 0–14). Breast cancer metastasized in 9% (8/93) of MRISC patients and in 23% (21/93) of controls (p = 0.009). MFS was better in MRISC patients overall (log‐rank p = 0.008, HR 0.36, 95% CI 0.16–0.80), with familial risk (log‐rank p = 0.024, HR: 0.21, 95% CI 0.04–0.95), and in BRCA1 mutation carriers (log‐rank p = 0.055, HR 0.30, 95% CI 0.08–1.13). MFS remained better in MRISC patients after lead time correction (log‐rank p = 0.020, HR 0.40, 95% CI 0.18–0.90). Overall survival was non‐significantly better in MRISC patients (log‐rank p = 0.064, HR 0.51, CI 0.24–1.06). Annual screening with MRI and mammography improves metastasis free survival in women with BRCA1 mutation or familial predisposition.
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In a study comparing MRI screening versus control in high-risk women, MRI-screened women had more frequent node-negative tumors (69% vs 44%, P = 0.001) and smaller tumors (87% vs 52%, P < 0.001).
“MRI-screened women had more frequent node negative (69% vs. 44%, P = 0.001) and smaller tumors (87% vs. 52%, P < 0.001)”
From Screening, Risk Reduction Strategies, and Clinical Management of Unaffected Carriers of <i>BRCA1</i> or <i>BRCA2</i> Pathogenic Variants (2026) · cites this paper as [36]
In that study, MRI-screened women received less hormonal therapy (14% vs 47%, P < 0.001) or chemotherapy (39% vs 77%, P < 0.001) than controls.
“received less hormonal therapy (14% vs. 47%, P < 0.001) or chemotherapy (39% vs. 77%, P < 0.001) than controls”
From Screening, Risk Reduction Strategies, and Clinical Management of Unaffected Carriers of <i>BRCA1</i> or <i>BRCA2</i> Pathogenic Variants (2026) · cites this paper as [36]
In that study, after a median follow-up of 9 years, overall survival was not significantly better in MRI-screened women (P = 0.064, HR 0.51, 95% CI 0.24-1.06).
“after a median follow-up of 9 years, overall survival was not significantly better in MRI-screened women (P = 0.064, hazard ratio (HR) 0.51, 95% confidence interval (CI), 0.24 - 1.06)”
From Screening, Risk Reduction Strategies, and Clinical Management of Unaffected Carriers of <i>BRCA1</i> or <i>BRCA2</i> Pathogenic Variants (2026) · cites this paper as [36]
High-risk MRI-based surveillance programs have not been shown to directly reduce breast cancer mortality.
“no direct reduction in cancer mortality was observed utilizing high-risk MRI-based surveillance program [36]”
From Screening, Risk Reduction Strategies, and Clinical Management of Unaffected Carriers of <i>BRCA1</i> or <i>BRCA2</i> Pathogenic Variants (2026) · cites this paper as [36]
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Lubinski, J., Kotsopoulos, J., Moller, P., Pal, T., Eisen, A., Peck, L., Karlan, B. Y., Aeilts, A., Eng, C., Bordeleau, L., et al. (2024) · JAMA Oncology · doi:10.1001/jamaoncol.2023.6944 · Cited by 82 · see citing works
Abdel-Razeq, H., & Mansour, R. (2026) · World Journal of Oncology · doi:10.14740/wjon2692
- Authors
- Saadatmand, S., Obdeijn, I., Rutgers, E. J., Oosterwijk, J. C., Tollenaar, R. A., Woldringh, G. H., Bergers, E., Verhoef, C., Heijnsdijk, E. A., Hooning, M. J., de Koning, H. J., & Tilanus‐Linthorst, M. M.
- Affiliations
- Erasmus MC (NL)
- The Netherlands Cancer Institute (NL)
- University Medical Center Groningen (NL)
- Leiden University Medical Center (NL)
- Radboud University Medical Center (NL)
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Department of Public Health Erasmus Medical Center Rotterdam The Netherlands
- Corresponding author
- Tilanus‐Linthorst, Madeleine M.
- Venue
- International Journal of Cancer
- Publisher
- Wiley
- Published
- 2015-04-17
- Volume
- 137
- Issue
- 7
- Pages
- 1729-1738
- ISSN
- 0020-7136 (ISSN-L)
- 1097-0215
- OpenAlex
- W1488207593
- Cited by
- 96
- References
- 0
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 8 · 2023: 6 · 2022: 11 · 2021: 7 · 2020: 14 · 2019: 10 · 2018: 9 · 2017: 8 · 2016: 10 · 2015: 3
- FWCI
- 7.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Leiden Repository (Leiden University) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Funders
- ZonMw, The Netherlands (6200.0005)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Digital Radiography and Breast Imaging
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › MRI in cancer diagnosis
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Keywords
- breast cancer screening, breast MRI, BRCA1 mutation, BRCA2 mutation, familial breast cancer risk, metastasis-free survival, overall survival, mammography, breast cancer early detection, lead-time bias, high-risk women, metastasis risk stratification, risk-adapted screening, risk-adapted treatment
- MeSH terms
- Adult, Aged, Breast Neoplasms, Female, Humans, Magnetic Resonance Imaging, Middle Aged, Mutation, Netherlands, Prospective Studies, Case-Control Studies, Genes, BRCA1, Genetic Predisposition to Disease
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