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Neues zum Hochrisikomammascreening

New information on high risk breast screening

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Zusammenfassung

Frauen mit erhöhtem Brustkrebsrisko benötigen ein frühzeitig einsetzendes und intensives Brustkrebsscreening. Ein solches Hochriskoscreening divergiert deutlich vom Brustkrebsscreening in der Normalbevölkerung. Nach Evaluierung des genauen Risikos durch einen Experten sollte, angepasst an die individuelle Risikokategorie, spätestens ab dem 30. Lebensjahr zumindest einmal pro Jahr eine Brust-MRT angeboten werden, ergänzende Mammographien erst ab dem 35. Lebensjahr. Die zusätzliche Ultraschalluntersuchung wird nicht mehr empfohlen. Um eine hohe Sensitivität und Spezifität zu gewährleisten, soll das Hochrisikoscreening ausschließlich in akkreditierten Brustzentren durchgeführt werden. Ausreichende Kenntnisse über die phänotypischen Eigenheiten des familiären Brustkrebses sind essenziell. Dazu gehören neben den herkömmlichen malignen Phänotypen eine häufig benigne imponierende Morphologie (runde oder ovale Form, glatte Begrenzung) und eine niedrige Prävalenz von Kalzifikationen. In der MRT-Bildgebung kommen häufig eine benigne Kontrastmittelkinetik sowie eine nicht solide Anreicherung mit fokalem, regionalem oder segmentalem Enhancement zur Darstellung.

Abstract

Women with an elevated risk for breast cancer require intensified screening beginning at an early age. Such high risk screening differs considerably from screening in the general population. After an expert has evaluated the exact risk a breast MRI examination should be offered at least once a year and beginning latest at the age of 30 depending on the patients risk category. Complementary mammograms should not be performed before the age of 35. An additional ultrasound examination is no longer recommended. To ensure a high sensitivity and specificity high risk screening should be performed only at a nationally or regionally approved and audited service. Adequate knowledge about the phenotypical characteristics of familial breast cancer is essential. Besides the common malignant phenotypes, benign morphologies (round or oval shape and smooth margins) as well as a low prevalence of calcifications have been described. Using MRI benign contrast media kinetics as well as non-solid lesions with focal, regional and segmental enhancement can often be visualized.

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Authors and Affiliations

  1. Abteilung für Allgemeine Radiologie und Kinderradiologie, Division für Molekulare und Gender-Bildgebung, Universitätsklinik für Radiodiagnostik, Medizinische Universität Wien, Währinger Gürtel 18–20, A-1090, Wien, Österreich

    C.C. Riedl, L. Ponhold, R. Gruber, K. Pinker &  T.H. Helbich

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  1. C.C. Riedl
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  2. L. Ponhold
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  3. R. Gruber
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  4. K. Pinker
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  5. T.H. Helbich
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Corresponding author

Correspondence to T.H. Helbich.

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Unterstützt durch den Jubiläums-Fonds der Österreichischen Nationalbank, Projekt-Nr. 10866 und 13581

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Riedl, C., Ponhold, L., Gruber, R. et al. Neues zum Hochrisikomammascreening. Radiologe 50, 955–963 (2010). https://doi.org/10.1007/s00117-010-2011-z

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  • DOI: https://doi.org/10.1007/s00117-010-2011-z

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