Preoperative breast MR Imaging in patients with primary breast cancer has the potential to decrease the rate of repeated surgeries

Eur J Radiol. 2017 Sep:94:148-153. doi: 10.1016/j.ejrad.2017.06.020. Epub 2017 Jul 1.

Abstract

Purpose: The impact of preoperative MRI on re-excisions and mastectomy rate is discussed controversially in the literature. Aim of this study was to evaluate the effect of preoperative breast MRI on the surgical procedure and rate of repeated surgeries.

Material and methods: A total of 991 consecutive patients in the years 2009 and 2010 with 1036 primary breast cancers were retrospectively analyzed. Sixty percent (599 patients with 626 cancers) received preoperative breast MRI. Planned surgical procedures before and after MRI and numbers of repeated surgeries in patients with (MR+ ) and without preoperative MRI (MR-) were compared.

Results: The result of preoperative MRI changed the surgical procedure in 25% (157/626) of the cases. In 81% (127/157), MRI was beneficial for the patients, as otherwise occult carcinomas were removed (n=122) or further biopsy could be prevented (n=5). Mastectomy rates did not differ between MR+ and MR- group (39% vs. 39%). On multiple regression analysis, the MR+ group had a lower chance for repeated surgery (p<0.05).

Conclusion: Preoperative MRI could lower the chance for repeated surgery in patients with primary breast cancer. The rate of mastectomy did not differ between patients undergoing preoperative MRI and those who did not.

Keywords: Breast cancer; Breast imaging; Magnetic resonance imaging; Repeated surgeries; Staging.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast / pathology*
  • Breast Neoplasms / diagnostic imaging
  • Breast Neoplasms / pathology*
  • Female
  • Humans
  • Magnetic Resonance Imaging* / methods
  • Mastectomy / statistics & numerical data*
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Staging
  • Predictive Value of Tests
  • Preoperative Care*
  • Reoperation / statistics & numerical data*
  • Retrospective Studies
  • Unnecessary Procedures
  • Young Adult