AJR: Blood test may rule out need for repeat breast MRIs
Optimal scheduling of breast MRI exams can be achieved by a simple blood test searching for Serum progesterone concentrations related to the follicular phase (days three-14) of a normal menstrual cycle in premenopausal women with irregular cycles, said a recent analysis published in the December issue of the American Journal of Roentgenology.
The article, by Richard L. Ellis, M.D of the Norma J. Vinger Center for Breast Care in Lacrosse, Wis., stated that by using this method of timing breast MRIs, the number of false-positive findings and non-diagnostic examinations could be reduced.
Hormonal fluctuations during the menstrual cycle of premenopausal women have shown an uptake of gadolinium in normal breast tissue that can render dynamic breast MRI exams difficult to interpret, said Ellis.
Following the assessment, Ellis pointed out a number of other circumstances in which a blood test could be helpful in the timing of a breast MRI, due to hormone fluctuations.
Circumstances included:
The single-center analysis evaluated all patients who had breast MRI scans between Feb. 5, 2006 and July 16, 2008. The patients who were premenopausal and without a normal menstrual cycle and those whose serum progesterone concentrations had been obtained and used to help time the breast MRI exam were further identified by the researchers.
The goal of the analysis was to scan the patients one to four days of a serum progesterone concentration result greater than 1.5 ng/mL, but less that 4.7 nmol/L as this measurement was considered to correlate with the follicular phase of a typical 28-day cycle.
Altogether, of the 135 women who had undergone breast MRI scans, 11 women (8.1 percent, with an age range of 33–53 years) were premenopausal and without a normal menstrual cycle. Serum progesterone concentration levels were gathered in these 11 women and were used to schedule and perform breast MRI scans in correlation with the follicular phase of the menstrual cycle for all 11 women.
"None of the breast MRI scans performed in our small group of women resulted in high background enhancement of normal breast tissue requiring a repeat scan," concluded Ellis.
The article, by Richard L. Ellis, M.D of the Norma J. Vinger Center for Breast Care in Lacrosse, Wis., stated that by using this method of timing breast MRIs, the number of false-positive findings and non-diagnostic examinations could be reduced.
Hormonal fluctuations during the menstrual cycle of premenopausal women have shown an uptake of gadolinium in normal breast tissue that can render dynamic breast MRI exams difficult to interpret, said Ellis.
Following the assessment, Ellis pointed out a number of other circumstances in which a blood test could be helpful in the timing of a breast MRI, due to hormone fluctuations.
Circumstances included:
- premenopausal women who have undergone a hysterectomy but retain normally functioning ovaries;
- premenopausal women with induced irregular menstrual cycles due to oral or injectable contraceptives;
- premenopausal women undergoing chemotherapy with induced perimenopausal status; and,
- perimenopausal women with irregular menstrual cycles.
The single-center analysis evaluated all patients who had breast MRI scans between Feb. 5, 2006 and July 16, 2008. The patients who were premenopausal and without a normal menstrual cycle and those whose serum progesterone concentrations had been obtained and used to help time the breast MRI exam were further identified by the researchers.
The goal of the analysis was to scan the patients one to four days of a serum progesterone concentration result greater than 1.5 ng/mL, but less that 4.7 nmol/L as this measurement was considered to correlate with the follicular phase of a typical 28-day cycle.
Altogether, of the 135 women who had undergone breast MRI scans, 11 women (8.1 percent, with an age range of 33–53 years) were premenopausal and without a normal menstrual cycle. Serum progesterone concentration levels were gathered in these 11 women and were used to schedule and perform breast MRI scans in correlation with the follicular phase of the menstrual cycle for all 11 women.
"None of the breast MRI scans performed in our small group of women resulted in high background enhancement of normal breast tissue requiring a repeat scan," concluded Ellis.