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  • Oral presentation
  • Open Access

4.5: Diagnosing breast cancer in a high-risk cohort

  • 1,
  • 2,
  • 2,
  • 3 and
  • 2
Breast Cancer Research201315 (Suppl 1) :O5

  • Published:


  • Breast Cancer
  • Luminal
  • Young Woman
  • Cancer Type
  • Nodal Status


MRI is a common method for detecting breast cancer in women at high risk [1, 2] These women may instead be diagnosed mammographically or present symptomatically. The aim of this study was to investigate how breast cancer is diagnosed in high-risk women and determine whether there are specific characteristics related to the type of presentation.


A total of 125 high-risk patients with 134 breast cancers (69 BRCA, 65 family history) were managed at the Royal Marsden Hospital from 1994 to 2013. Following ethical approval, data were collected retrospectively for each presentation of breast cancer: method of presentation/diagnosis (MRI, mammography, symptomatic), age at diagnosis, cancer type, grade, size, presence of DCIS, lymphovascular invasion (LVI), nodal status and tumour subtype. Chi-squared and ANOVA analyses determined any association between the parameters, P < 0.05 was significant.


Ten breast cancers were MRI detected, 43 mammography detected and 81 symptomatic (mean age 41, 51, and 45 years (P = 0.008); mean size 17, 29, and 34 mm (P = 0.076) respectively).The majority of cancers were high-grade (68%) invasive ductal carcinomas (78%) without LVI (76%). MRI-detected cancers were triple negative in 60% (P = 0.03), node negative in 100% (P = 0.005) with DCIS in 70% (P = 0.007). Mammography-detected cancers were luminal in 77% (P = 0.03), node negative in 77% (P = 0.005), with DCIS in 81% (P = 0.007). Symptomatic cancers were luminal in 54%, triple negative in 41%, node negative in 56% and DCIS positive in 51%.


In this high-risk cohort, MRI detects small, triple-negative, node-negative cancers in younger women, while mammography detects larger, luminal, cancers in older women that may be node positive.

Authors’ Affiliations

Institute of Cancer Research and Royal Marsden Hospital, Sutton, UK
Royal Marsden Hospital, London, UK
Ninewells Hospital and Medical School, Dundee, UK


  1. Leach MO, et al: Lancet. 2005Google Scholar
  2. Kuhl CK, et al: JCO. 2005Google Scholar


© O'Flynn et al.; licensee BioMed Central Ltd. 2013

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.