This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related letter  • Similar articles in JAMA  Topic Collections  • Oncology  • Breast Cancer  • Magnetic Resonance Imaging  • Alert me on articles by topic

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Crystal questions our assumption that the minimal detectable size of a breast tumor on MRI is 5 mm. However, 5-mm invasive breast tumors have been identified on MRI screening examinations.^1-2 In our model, the size at which tumors are detected by screening depends on their minimal detectable size, their growth rate, and the frequency of screening. We found that at the time tumors are screened, most screen-detectable tumors are larger than their minimal detectable size. Our estimate for the tumor size distribution at detection (Table 5 in our article) is consistent with Crystal's summary of published data; however, a statistical comparison is not meaningful due to the small sample sizes in each study.

The size at which a suspicious breast lesion is regarded as warranting diagnostic evaluation influences the false-positive rate. Liberman et al³ retrospectively reviewed a series of MRI-detected cancers among patients who were referred to . . . [Full Text of this Article]

Sylvia K. Plevritis, PhD
sylvia.plevritis@stanford.edu

Debra M. Ikeda, MD
Department of Radiology
Stanford University School of Medicine
Stanford, Calif

Alan M. Garber, MD, PhD
VA Palo Alto Health Care System
Palo Alto, Calif

RELATED LETTER

Cost-effectiveness of Breast Magnetic Resonance Imaging to Screen BRCA1/2 Mutation Carriers
Pavel Crystal
JAMA. 2006;296(22):2681-2682.
EXTRACT | FULL TEXT