The Effects of Adding Preoperative Magnetic Resonance Imaging to Patients with Invasive Cancer Eligible for Breast Conserving Surgery: A Comparative Study
Abstract
Data di Pubblicazione:
2013
Citazione:
The Effects of Adding Preoperative Magnetic Resonance Imaging to Patients with Invasive Cancer Eligible for Breast Conserving Surgery: A Comparative Study / Fancellu, Alessandro; Soro, D; Castiglia, Paolo Giuseppino; Marras, V; Melis, M; Cottu, P; Mulas, S; Cherchi, A; Pusceddu, C; Simula, S; Meloni, Giovanni Battista. - In: ANNALS OF SURGICAL ONCOLOGY. - ISSN 1068-9265. - 20:1(2013), pp. S67-S67.
Abstract:
Introduction: Magnetic resonance imaging (MRI) have been widely used in evaluation of
patients with newly detected breast cancer, however its role in preoperative planning remains controversial.
We investigated whether pre-operative (MRI) influence surgical planning, rates of positive margins, and
mastectomy rates, when added to preoperative work-up of patients with infiltrating carcinoma (IBC) eligible for
breast conserving surgery (BCS).
Methods: This is a retrospective analysis on 237 patients with IBC suitable for BCS on the basis of standard
triple assessment (i.e. physical exam, mammography and ultrasonosgraphy) and treated during the period
January 2009-June 2011. Of those, 109 underwent preoperative MRI (46%, MRI-group) and 128 did not (54%,
no-MRI group). Variations in surgical treatment due to MRI were evaluated, and both rates of re-operations for
initial positive margins and mastectomy rates compared in the two study groups.
Results: Demographic data, histopathological characteristics, and tumor stage were similar. Tumor size was
bigger in the MRI-group (16.8 mm vs. 13.9 mm, p<0.001). MRI changed the initial surgical planning in 18/109
patients (16.5%). Reasons for change in treatment plan included detection of larger tumor diameter requiring
wider resection (8 cases, 7.3%) or finding of additional malignant lesions in either ipsilateral (9 cases, 8.2%)
or contralateral breast (1 case, 0.9%). MRI-triggered treatment changes were mastectomy (N=12), wider
excision (N=5) and contralateral BCS (N=1). Rates of re-excision for positive margins after primary BCS
attempt appeared higher in the no-MRI group (4.1% vs 8.6%) but the difference missed statistical significance
(p=0.9). Overall mastectomy rates were higher in the MRI-group (13.7% vs 7.0%, p<0.05).
Conclusions: In our experience preoperative MRI altered the original treatment plan in more than 16% of
patients. MRI was associated with higher mastectomy rates justified by detection of additional foci of
carcinoma, but did not significantly reduce the re-excision rates for positive margins.
patients with newly detected breast cancer, however its role in preoperative planning remains controversial.
We investigated whether pre-operative (MRI) influence surgical planning, rates of positive margins, and
mastectomy rates, when added to preoperative work-up of patients with infiltrating carcinoma (IBC) eligible for
breast conserving surgery (BCS).
Methods: This is a retrospective analysis on 237 patients with IBC suitable for BCS on the basis of standard
triple assessment (i.e. physical exam, mammography and ultrasonosgraphy) and treated during the period
January 2009-June 2011. Of those, 109 underwent preoperative MRI (46%, MRI-group) and 128 did not (54%,
no-MRI group). Variations in surgical treatment due to MRI were evaluated, and both rates of re-operations for
initial positive margins and mastectomy rates compared in the two study groups.
Results: Demographic data, histopathological characteristics, and tumor stage were similar. Tumor size was
bigger in the MRI-group (16.8 mm vs. 13.9 mm, p<0.001). MRI changed the initial surgical planning in 18/109
patients (16.5%). Reasons for change in treatment plan included detection of larger tumor diameter requiring
wider resection (8 cases, 7.3%) or finding of additional malignant lesions in either ipsilateral (9 cases, 8.2%)
or contralateral breast (1 case, 0.9%). MRI-triggered treatment changes were mastectomy (N=12), wider
excision (N=5) and contralateral BCS (N=1). Rates of re-excision for positive margins after primary BCS
attempt appeared higher in the no-MRI group (4.1% vs 8.6%) but the difference missed statistical significance
(p=0.9). Overall mastectomy rates were higher in the MRI-group (13.7% vs 7.0%, p<0.05).
Conclusions: In our experience preoperative MRI altered the original treatment plan in more than 16% of
patients. MRI was associated with higher mastectomy rates justified by detection of additional foci of
carcinoma, but did not significantly reduce the re-excision rates for positive margins.
Tipologia CRIS:
1.5 Abstract in rivista
Elenco autori:
Fancellu, Alessandro; Soro, D; Castiglia, Paolo Giuseppino; Marras, V; Melis, M; Cottu, P; Mulas, S; Cherchi, A; Pusceddu, C; Simula, S; Meloni, Giovanni Battista
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