Authors' objectives:

This Technical Brief identified and appraised the international evidence for surveillance of women at high risk of breast cancer. The accuracy and health outcome of the following modalities of surveillance were assessed in comparison to normal care: mammography (XRM), ultrasound (US) and magnetic resonance imaging (MRI).

Authors' recommendations: In conclusion, MRI alone or in combination with other surveillance modalities appears to be a promising strategy for the surveillance of women at high risk of breast cancer. However, there is no evidence currently to suggest that such surveillance will necessarily translate to a decrease in mortality among this population. More research with larger numbers of participants and longer follow-up is required to truly assess the performance of MRI and combination strategies for the surveillance of women at high risk of breast cancer. In addition to its accuracy, MRI has the advantage of not using ionising radiation. The drawbacks of MRI are primarily related to the potential harm of false-positive diagnoses, cost and availability. If the introduction of a surveillance strategy for women at high risk of breast cancer with MRI was to be contemplated, a more complete assessment would need to be carried out. This should include the potential benefit from surveillance versus the potential physical and psychological harm caused by the test, diagnostic procedures and treatment; the health care system being capable of supporting all the necessary elements of the surveillance pathway, including diagnosis, follow-up and evaluation; consideration of social and ethical issues and consideration of cost-benefit issues.

Authors' methods: Review

Project Status: Completed

URL for project: http://nzhta.chmeds.ac.nz/publications.htm

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: New Zealand

Organisation Name: New Zealand Health Technology Assessment

Contact Address: Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, P.O. Box 4345, Christchurch, New Zealand. Tel: +64 3 364 1145; Fax: +64 3 364 1152;

Contact Name: nzhta@chmeds.ac.nz

Contact Email: nzhta@chmeds.ac.nz

Copyright: New Zealand Health Technology Assessment (NZHTA)