{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T13:17:43Z","timestamp":1763644663961,"version":"3.45.0"},"reference-count":39,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the European Union \u2013 operational program East (EFRO \u2013 OP Oost)."}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study evaluates breast cancer (BC) detection in women with \u2265 20% lifetime risk who discontinued annual breast MRI screening surveillance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>This retrospective single screening cohort (2003\u20132019) study included 3308 women who received at least one breast MRI. After verifying with the Netherlands Comprehensive Cancer Organization (IKNL), a sub-population of women who developed BC after discontinuation was identified. Screening indications, BC incidence rates, tumor characteristics, and reasons for MRI screening discontinuation were compared between women who continued and those who discontinued MRI screening using descriptive and inferential methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 3308 participants, 2647 discontinued MRI screening. After discontinuation, 58\/2647 (2.2%) developed BC (43 invasive, 13 DCIS, 2 NA). Initial screening indications included: personal (26\/58, 44.8%) or family history (17\/58, 29.3%) of BC, BRCA1 (3\/58, 5.2%), BRCA2 (1\/58, 1.7%), chest irradiation (1\/58, 1.7%), other mutations (2\/58, 3.4%) and other (8\/58, 13.8%). Of these, 27 continued mammography screening, detecting 23 BC-cases. Discontinuation was mainly physician-driven. Invasive tumor size after cessation of MRI screening tended to be larger compared to tumors detected while participating in MRI screening (median difference: 7.0\u2009mm, 95% CI: 4.0\u201310.0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Mean age at diagnosis was 58. Median time from last MRI to diagnosis was 5.9 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Women with a personal or family history of BC commonly discontinued MRI screening, often influenced by referring physicians. However, after cessation of MRI screening, a substantial number of these women are still diagnosed with BC, challenging current MRI screening regulations. Although a last negative MRI appears to reduce the subsequent decade\u2019s likelihood of BC, post-MRI discontinuation detected tumors are prognostically worse, highlighting the need for more personalized, extended screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Question<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Current regulations and duration of MRI screening do not suit the entire increased-risk population<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Findings<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Early discontinuation disproportionately affects women with a personal or family history. Cancers detected after cessation of MRI screening seem larger and more often invasive<\/jats:italic>\n                      .\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:bold>\n                        <jats:italic>Clinical relevance<\/jats:italic>\n                      <\/jats:bold>\n                      <jats:italic>Because certain women with a personal or family risk indication could benefit from a longer duration of MRI screening, extended, personalized screening beyond current guidelines is suggested<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical Abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-025-11718-7","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T15:47:05Z","timestamp":1749743225000},"page":"8202-8213","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Breast cancer in women after withdrawing from an increased-risk MRI screening program"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7273-4386","authenticated-orcid":false,"given":"Suzanne L.","family":"van Winkel","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Samperna","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth A.","family":"Loehrer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline A.","family":"Drukker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelly","family":"Sessink","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nico","family":"Karssemeijer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ritse M.","family":"Mann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"11718_CR1","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1093\/eurpub\/cku088","volume":"25","author":"D van der Waal","year":"2014","unstructured":"van der Waal D, Verbeek ALM, den Heeten GJ, Ripping TM, Tjan-Heijnen VCG, Broeders MJMB (2014) Breast cancer diagnosis and death in the Netherlands: a changing burden. 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Mann, MD, PhD.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The authors of this manuscript declare relationships with the following companies: N.K.: CSO ScreenPoint Medical, shareholder of Volpara. R.M.: Shares a collaborative European funding in which ScreenPoint Medical is a partner, is part of the Medical Advisory Board of ScreenPoint Medical, has grants\/grants pending with Bayer Healthcare, Siemens Healthineers, Medtronic, BD, Koning, and Seno Medical. R.M. is a member of the Advisory Editorial Board of\n                      European Radiology\n                      (European Society of Breast Imaging) and, as such, has not participated in the selection or review processes for this article. The remaining authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper. Suzanne L. van Winkel, RN, MSc (first author) and Elizabeth A. Loehrer, PhD, are clinical epidemiologists. Both authors have completed advanced master\u2019s-level training in epidemiology, including statistics and biometry. Elizabeth A. Loehrer has already gained substantial experience in this field and kindly provided advice when appropriate or required.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board due to the large-scale retrospective nature of the research and because it was classified as Non-WMO research under Dutch law (Medical Research Involving Human Subjects Act). Active objection in the electronic patient record (EPR) against anonymous data reuse for research was an exclusion criterion.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was not required because this retrospective observational study was classified as Non-WMO research under Dutch law (Medical Research Involving Human Subjects Act). The study adhered to national privacy protection guidelines and was registered by the ethical committee (CMO registration number 2020-6325).","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"There is no overlap with other study subjects or cohorts. However, some of our research projects with very different purposes and information extraction may involve some overlap in the cohort, though this does not include any published articles.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}