Multinational prospective study of association of MRI surveillance with breast cancer mortality in women with BRCA1/2 pathogenic variants

Magnetic resonance imaging (MRI) surveillance is offered to women with a pathogenic variant in the BRCA1 or BRCA2 gene who face a high lifetime risk of breast cancer. MRI surveillance is effective in downstaging breast cancers, but the association of MRI surveillance with mortality risk has not been well defined. A multinational cohort study included 1442 women with BRCA1 and 314 with BRCA2 sequence variations who underwent a mean of 4.7 screening MRI examinations. At 20 years, the risk of breast cancer mortality was 3.2% in the MRI surveillance group compared with 14.9 in the group without MRI surveillance. The age-adjusted HRs for breast cancer mortality associated with entering an MRI surveillance program were 0,20 (p<0.001) for women with BRCA1 sequence variations and 0.87 (p=0.93) for women with BRCA2 sequence variations. The authors conclude that among women with a BRCA1 sequence variation, MRI surveillance was associated with reduced breast cancer mortality risk.