Tracy Onega1,2, Julie E Weiss2, Martha E Goodrich2, Weiwei Zhu3, Wendy B DeMartini4, Karla Kerlikowske5, Elissa Ozanne1, Anna N A Tosteson1, Louise M Henderson6, Diana S M Buist3, Karen J Wernli3, Sally D Herschorn7,8, Elise Hotaling8, Cristina O'Donoghue9, Rebecca Hubbard10. 1. The Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 2. Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire. 3. Group Health Research Institute, Seattle, Washington. 4. Department of Radiology, Stanford University Medical Center, Stanford, California. 5. Departments of Medicine and Epidemiology and Biostatistics, University of California, San Francisco, California. 6. Department of Radiology, The University of North Carolina, Chapel Hill, North Carolina. 7. University of Vermont and Vermont Cancer Center, Burlington, Vermont. 8. Department of Radiology, University of Vermont, Burlington, Vermont. 9. Surgical Oncology, Moffitt Cancer Center, Tampa, Florida. 10. Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.
Abstract
BACKGROUND AND OBJECTIVES: More extensive surgical treatments for early stage breast cancer are increasing. The patterns of preoperative MRI overall and by stage for this trend has not been well established. METHODS: Using Breast Cancer Surveillance Consortium registry data from 2010 through 2014, we identified women with an incident non-metastatic breast cancer and determined use of preoperative MRI and initial surgical treatment (mastectomy, with or without contralateral prophylactic mastectomy (CPM), reconstruction, and breast conserving surgery ± radiation). Clinical and sociodemographic covariates were included in multivariable logistic regression models to estimate adjusted odds ratios and 95% confidence intervals. RESULTS: Of the 13 097 women, 2217 (16.9%) had a preoperative MRI. Among the women with MRI, results indicated 32% higher odds of unilateral mastectomy compared to breast conserving surgery and of mastectomy with CPM compared to unilateral mastectomy. Women with preoperative MRI also had 56% higher odds of reconstruction. CONCLUSION: Preoperative MRI in women with DCIS and early stage invasive breast cancer is associated with more frequent mastectomy, CPM, and reconstruction surgical treatment. Use of more extensive surgical treatment and reconstruction among women with DCIS and early stage invasive cancer whom undergo MRI warrants further investigation.
BACKGROUND AND OBJECTIVES: More extensive surgical treatments for early stage breast cancer are increasing. The patterns of preoperative MRI overall and by stage for this trend has not been well established. METHODS: Using Breast Cancer Surveillance Consortium registry data from 2010 through 2014, we identified women with an incident non-metastatic breast cancer and determined use of preoperative MRI and initial surgical treatment (mastectomy, with or without contralateral prophylactic mastectomy (CPM), reconstruction, and breast conserving surgery ± radiation). Clinical and sociodemographic covariates were included in multivariable logistic regression models to estimate adjusted odds ratios and 95% confidence intervals. RESULTS: Of the 13 097 women, 2217 (16.9%) had a preoperative MRI. Among the women with MRI, results indicated 32% higher odds of unilateral mastectomy compared to breast conserving surgery and of mastectomy with CPM compared to unilateral mastectomy. Women with preoperative MRI also had 56% higher odds of reconstruction. CONCLUSION: Preoperative MRI in women with DCIS and early stage invasive breast cancer is associated with more frequent mastectomy, CPM, and reconstruction surgical treatment. Use of more extensive surgical treatment and reconstruction among women with DCIS and early stage invasive cancer whom undergo MRI warrants further investigation.
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