Preoperative breast MRI doesn't increase mastectomy rates

Sunday, November 28 | 11:25 a.m.-11:35 a.m. | SSA01-05 | Arie Crown Theater
Preoperative MRI can be used in clinical practice for breast cancer staging without boosting mastectomy rates, according to researchers from the University of Milan School of Medicine.

In this Sunday morning session, Fabio Chiesa and colleagues will present results from a study they conducted from January 2003 to December 2008. For the study cohort, the team identified 1,522 breast surgical procedures that had been performed, sorting them to 983 cases that were clinically indicated for the removal of biopsy-proven cancer.

Of 983 patients, 168 underwent mastectomy, while 105 patients had preoperative staging MRI. The mastectomy rate for the total number of performed surgical treatments was:

  • 25 of 121 (20.7%) in 2003
  • 25 of 159 (15.7%) in 2004
  • 22 of 140 (15.7%) in 2005
  • 21 of 161 (13%) in 2006
  • 26 of 182 (14.3%) in 2007
  • 49 of 220 (21.4%) in 2008

There were three preoperative MRI examinations in 2003, two in 2004, 13 in 2005, 14 in 2006, 31 in 2007, and 42 in 2008, Chiesa's team found. Although radiologists had increasingly used MRI for surgical planning of breast cancer patients during the study period, the total mastectomy rate remained less than 22%.

For the five-year period, the overall mastectomy rate was 168 out of 983 (17.1%); patients who had preoperative MRI had a mastectomy rate of 37.1%, while patients staged without MRI had a rate of 14.6%. Chiesa's team attributed the higher mastectomy rate in patients who had preoperative MRI to use of the modality in those suspected of extensive disease at clinical examination and conventional imaging.

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