The impact of breast MRI on the surgical management of breast cancer

613 Background: To evaluate the impact of preoperative magnetic resonance imaging (MRI) of the breast on the clinical management of patients with operable breast cancer (BC). Methods: Retrospective analysis of 160 patients with operable breast cancer (stages Tis, through T4), who were treated from 2002 through 2004. All patients underwent a full mammographic assessment, high frequency breast ultrasound, and breast MRI. The impact of preoperative MRI was evaluated for each patient with regard to changes in the therapeutic procedure. Patient and tumor characteristics were analysed to identify possible patient subgroups that predominantly benefit from preoperative MRI. Results: Preoperative MRI affected the clinical management in 44 of 160 patients (27.5%). In 30 cases (18.75%) additional in-situ or invasive cancers or a more widespread tumor extent were diagnosed correctly which went undetected by clinical palpation, mammography, and breast ultrasound. In 14 cases (8.75%) additional, surgical procedures were performed based on suspicious MRI findings with benign pathology. Age, menopausal status, breast density, tumor characteristics (type, tumor size, grading), ER-, PR- and HER2- receptor features did not significantly differ between patients in which breast MRI affected the clinical management and patients that experienced no additional information from MRI. Conclusions: Preoperative breast MRI changes surgical management in a considerable amount of patients with operable breast cancer. MRI detects additional invasive carcinoma and proves to be a meaningful supplement to the conventional work-up in the clinical management of breast cancer. This benefit is independent from patients and tumor characteristics. No significant financial relationships to disclose.

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231. The effect of preoperative breast MRI on the surgical management of ductal carcinoma in situ and the risk of contralateral breast cancer

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2016.06.163 ◽

2016 ◽

Vol 42 (9) ◽

pp. S129

Author(s):

K. Keymeulen ◽

E. Heuts ◽

M. Lobbes ◽

A. Voogd ◽

V. Tjan-Heijnen

Keyword(s):

Breast Cancer ◽

Surgical Management ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Contralateral Breast Cancer ◽

Ductal Carcinoma ◽

Breast Mri ◽

Contralateral Breast ◽

Preoperative Breast Mri

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The impact of preoperative breast MRI on the surgical management of newly diagnosed non metastatic breast cancers

International Journal of Current Research in Medical Sciences ◽

10.22192/ijcrms.2017.03.05.016 ◽

2017 ◽

Vol 3 (5) ◽

pp. 111-121

Author(s):

Col (Dr.) Puneet Takkar ◽

◽

Surg Lt Cdr (Dr.) Hari JP ◽

Surg Lt Cdr (Dr.) Khushdeep Kaur ◽

◽

...

Keyword(s):

Surgical Management ◽

Metastatic Breast ◽

Breast Mri ◽

Breast Cancers ◽

Newly Diagnosed ◽

Preoperative Breast Mri ◽

The Impact

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Investigating the impact of neoadjuvant chemotherapy and herceptin on the surgical management of patients with invasive breast cancer

International Journal of Surgery ◽

10.1016/j.ijsu.2012.06.078 ◽

2012 ◽

Vol 10 (8) ◽

pp. S14

Author(s):

Terri McVeigh ◽

Dhafir Al-Azawi ◽

Karl Sweeney ◽

Carmel Malone ◽

Maccon Keane ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Surgical Management ◽

Invasive Breast Cancer ◽

The Impact

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The impact of breast MRI workup on tumor size assessment and surgical planning in patients with early breast cancer

The Breast Journal ◽

10.1111/tbj.13104 ◽

2018 ◽

Vol 24 (6) ◽

pp. 927-933 ◽

Cited By ~ 6

Author(s):

Catalin-Florin Pop ◽

Claudia Stanciu-Pop ◽

Stylianos Drisis ◽

Magali Radermeker ◽

Carine Vandemerckt ◽

...

Keyword(s):

Breast Cancer ◽

Early Breast Cancer ◽

Tumor Size ◽

Surgical Planning ◽

Breast Mri ◽

The Impact

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The use of breast MRI in early-stage breast cancer: Findings after implementation of an institutional protocol at a county hospital.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.26_suppl.5 ◽

2014 ◽

Vol 32 (26_suppl) ◽

pp. 5-5

Author(s):

Stewart Whitney ◽

Nestor Arita ◽

Jessica LaCross ◽

Brian Lassinger ◽

Elizabeth Bonefas ◽

...

Keyword(s):

Breast Cancer ◽

Median Time ◽

Surgical Management ◽

Early Stage ◽

Breast Mri ◽

Surgical Pathology ◽

Early Stage Breast Cancer ◽

Partial Mastectomy ◽

Index Lesion ◽

Pathologic Diagnosis

5 Background: Breast MRI has recently become standard-of-care in many practices, however, its proper utility in the preoperative management of early-stage breast cancer has not been fully elucidated. Our program recently instituted a protocol to obtain breast MRI at the time of diagnosis of breast cancer. We report the outcomes of this new approach in patients with surgically resected, early-stage breast cancer. Methods: An institutional database was queried for all patients that underwent surgery after a new histopathologic diagnosis of either noninvasive or invasive breast cancer from November 2012, the time of protocol implementation, through March 2014. Patients that received neoadjuvant treatment and patients with stage IV disease were excluded. Demographic, diagnosti,c and clinical data were extracted and analyzed using summary statistics and student’s t-test. Results: Fifty-eight patients met criteria. The median size of the index lesion on mammogram, ultrasound, MRI, and final surgical pathology was 1.2, 1.4, 2.1, and 1.3 cm, respectively. MRI size was significantly larger than mammogram, ultrasound, and final surgical pathology size (p < 0.05). The median time between initial pathologic diagnosis and breast MRI was 16 days. MRI identified 20 additional lesions in 19 (33%) patients leading to 14 additional biopsies and the diagnosis of two additional invasive and two noninvasive cancers. The median time between initial pathologic diagnosis and final report of these 14 biopsies was 36 days. Nine (64%) of the 14 patients that underwent a second biopsy went on to have a partial mastectomy, all with negative margins. Of the remaining five patients that went on to have total mastectomy, all but one were offered partial mastectomy but desired reconstruction. Conclusions: In this cohort of patients with early-stage breast cancer, MRI overestimated the size of the index lesion when compared to other imaging modalities and final surgical pathologic size. The use of MRI did not alter the surgical management in the majority of cases and increased the time from initial diagnosis to definitive surgical management. More studies are needed to determine the role of breast MRI in early-stage breast cancer.

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The Impact of Preoperative Breast MRI on Surgical Management of Women with Newly Diagnosed Ductal Carcinoma In Situ

Academic Radiology ◽

10.1016/j.acra.2019.05.013 ◽

2020 ◽

Vol 27 (4) ◽

pp. 478-486 ◽

Cited By ~ 7

Author(s):

Diana L. Lam ◽

Jacob Smith ◽

Savannah C. Partridge ◽

Adrienne Kim ◽

Sara H. Javid ◽

...

Keyword(s):

Surgical Management ◽

Ductal Carcinoma In Situ ◽

Carcinoma In Situ ◽

Ductal Carcinoma ◽

Breast Mri ◽

Newly Diagnosed ◽

Preoperative Breast Mri ◽

The Impact

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Correlation of tumor size on preoperative breast MRI and pathologic tumor size in Asian patients

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e11546 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e11546-e11546

Author(s):

S. Lee ◽

S. Kim ◽

H. Kang ◽

E. Lee ◽

E. Kim ◽

...

Keyword(s):

Breast Cancer ◽

Tumor Size ◽

Breast Mri ◽

Positive Margin ◽

Breast Cancer Surgery ◽

Asian Patients ◽

Positive Margin Rate ◽

Preoperative Breast Mri ◽

Intraoperative Conversion ◽

The Impact

e11546 Background: As many Asian patients want breast conserving therapy (BCT), use of magnetic resonance imaging (MRI) increase in preoperative diagnosis for breast cancer. But the impact of MRI on these patients has not been unclear. Methods: From January 2008 to July 2008, 423 patients underwent breast cancer surgery in National Cancer Center, Korea. We enrolled 357 patients consecutively in this retrospective study; 290 patients (non-MRI group) with preoperative mammography (MMG) and ultrasonography (US) vs. 66 patients (MRI group) with additional MRI to MMG, US and excluded 67 patients (42 patients with preoperative chemotherapy, 8 patients with ipsilateral recurrence, 17 patients whose MRI showed no residual lesion after excisional biopsy). We examined MRI effect on mastectomy rate, intraoperative conversion from BCT to mastectomy, positive margin rate in frozen specimen in both group. In MRI group, we evaluated the correlation between tumor size on US, MRI and pathologic tumor size. Results: Mean age of this study was 48.89 years (Non-MRI group: 50.70 years vs. MRI group: 46.33 years, p=0.001). The rate of mastectomy wasn’t different in both groups (Non-MRI group: 13.7% vs. MRI group: 19.4%, p=0.252). Intraoperative conversion to mastectomy was performed frequently in MRI group. (Non-MRI group: 1.7% vs. MRI group: 7.5%, p=0.023). But positive margin rate in frozen specimen was similar in both groups (Non-MRI group: 23.2% vs. MRI group: 34.0%, p=0.111). In MRI group, mean tumor size on MRI, US was 3.07cm, 1.98cm respectively. Mean pathologic tumor size was 2.67cm. The tumor size on MRI correlated strongly with the pathologic tumor size. The correlation coefficient was 0.732 (p=0.0001). But the tumor size on US didn’t correlate with the pathologic tumor size (p=0.066). In twenty nine patients whose MMG showed suspicious microcalcification, tumor size on MRI also correlated strongly with pathologic tumor size. The correlation coefficient was 0.693 (p=0.0001). But US didn’t show the correlation with the pathologic tumor size in these patients. Conclusions: Preoperative breast MRI didn’t give the impact on breast cancer surgery in Asian patients and could overestimate the size of tumor. But it could strongly correlate with the pathologic tumor size in Asian patients. No significant financial relationships to disclose.

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