BACKGROUND: The role of preoperative bilateral breast MRI in breast cancer patients being considered for breast-conserving therapy has been controversial. We hypothesized that preoperative MRI, along with an active program in MRI-directed biopsies, would lead to a change in multidisciplinary treatment planning for patients being considered for breast-conserving cancer therapy, and it would be associated with reduced rates of margin-positive partial mastectomies. STUDY DESIGN: A retrospective review of a consecutive series of patients who were treated for breast cancer at a single center between January 2005 and July 2007 was conducted. Patients in the study were candidates for breast-conserving cancer therapy based on physical examination, mammography, and ultrasonography. All patients were evaluated by a preoperative breast MRI. Analysis included number and result of MRI-directed biopsies, impact of MRI on treatment planning, and incidence of margin-positive partial mastectomy within the series of patients. RESULTS: Seventy-nine female patients were analyzed. Median age was 57 years. MRI led to the performance of 25 MRI-directed biopsies for previously unrecognized suspicious lesions in 21 patients. Forty-four percent of MRI-directed biopsies were positive for cancer. MRI was associated with a change in management in 15 patients (19%) for multicentric ipsilateral cancer (n = 7), a more extensive primary lesion size (n = 6), or contralateral breast cancer (n = 2). Incidence of margin-positive partial mastectomy requiring additional resective operation was very low in this series (10%). CONCLUSIONS: Bilateral breast MRI, when used in conjunction with MRI-directed biopsy procedures, can be helpful in planning multidisciplinary treatment of candidates for breast-conserving cancer therapy. By allowing more accurate local staging of tumors, MRI is a tool that can be used to help reduce high reexcision rates for margin-positive partial mastectomies.
BACKGROUND: The role of preoperative bilateral breast MRI in breast cancerpatients being considered for breast-conserving therapy has been controversial. We hypothesized that preoperative MRI, along with an active program in MRI-directed biopsies, would lead to a change in multidisciplinary treatment planning for patients being considered for breast-conserving cancer therapy, and it would be associated with reduced rates of margin-positive partial mastectomies. STUDY DESIGN: A retrospective review of a consecutive series of patients who were treated for breast cancer at a single center between January 2005 and July 2007 was conducted. Patients in the study were candidates for breast-conserving cancer therapy based on physical examination, mammography, and ultrasonography. All patients were evaluated by a preoperative breast MRI. Analysis included number and result of MRI-directed biopsies, impact of MRI on treatment planning, and incidence of margin-positive partial mastectomy within the series of patients. RESULTS: Seventy-nine female patients were analyzed. Median age was 57 years. MRI led to the performance of 25 MRI-directed biopsies for previously unrecognized suspicious lesions in 21 patients. Forty-four percent of MRI-directed biopsies were positive for cancer. MRI was associated with a change in management in 15 patients (19%) for multicentric ipsilateral cancer (n = 7), a more extensive primary lesion size (n = 6), or contralateral breast cancer (n = 2). Incidence of margin-positive partial mastectomy requiring additional resective operation was very low in this series (10%). CONCLUSIONS: Bilateral breast MRI, when used in conjunction with MRI-directed biopsy procedures, can be helpful in planning multidisciplinary treatment of candidates for breast-conserving cancer therapy. By allowing more accurate local staging of tumors, MRI is a tool that can be used to help reduce high reexcision rates for margin-positive partial mastectomies.
Authors: Kandace P McGuire; E Shelley Hwang; Alan Cantor; Mehra Golshan; Funda Meric-Bernstam; Janet K Horton; Rita Nanda; Keith D Amos; Andres Forero; Cliff A Hudis; Ingrid Meszoely; Jennifer F De Los Santos Journal: Ann Surg Oncol Date: 2014-07-25 Impact factor: 5.344
Authors: Richard J Bleicher; Robin M Ciocca; Brian L Egleston; Linda Sesa; Kathryn Evers; Elin R Sigurdson; Monica Morrow Journal: J Am Coll Surg Date: 2009-06-18 Impact factor: 6.113
Authors: Kelli Pettit; Mary Ellen Swatske; Feng Gao; Lorena Salavaggione; William E Gillanders; Rebecca L Aft; Barbara S Monsees; Timothy J Eberlein; Julie A Margenthaler Journal: J Surg Oncol Date: 2009-12-01 Impact factor: 3.454
Authors: Monica Morrow; Reshma Jagsi; Amy K Alderman; Jennifer J Griggs; Sarah T Hawley; Ann S Hamilton; John J Graff; Steven J Katz Journal: JAMA Date: 2009-10-14 Impact factor: 56.272
Authors: Som D Mukherjee; Nicole Hodgson; Peter J Lovrics; Kavita Dhamanaskar; Terry Minuk; Shelley Chambers; Jonathan Sussman Journal: Breast Cancer (Auckl) Date: 2016-05-17