Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
In Reply: We agree with Dr Helvie that the
fact that most of the patients in our study received previous mammography
but not MRI could artificially increase the difference in sensitivity between
MRI and mammography observed in the first round of screening (85% vs 38%).
However, since the performance of the data analysis on which our article was
based, most of the patients in the published cohort have had 1 or 2 additional
rounds of screening. There have been 7 additional cancers identified in this
cohort (1 on screen 2, 3 on screen 4, and 3 on screen 5); all 7 were detected
by screening MRI but only 2 were detected by screening mammography. Therefore,
of the total of 16 incident cancers, 13 (81%) were detected by MRI and 5 (31%)
by mammography. These findings are almost identical with those in a recent
update of the Dutch National Study.1
Warner E, Jong R, Plewes D, Yaffe M, Narod S. Surveillance of. JAMA. 2005;293(8):931. doi:10.1001/jama.293.8.931-b