Influence of preoperative magnetic resonance imaging on the surgical management of breast cancer patients

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• 作者：Armen Parsyan ; M.D. ; Ph.D. ; M.P.H.^a ; Dan Moldoveanu ; M.D.^a ; Bhairavi Balram ; M.D.^a ; Stephanie Wong ; M.D.^a ; David Dong Qi Zhang ; M.D.^b ; Anita Svadzian ; B.A.^c ; Alexandra Allard-Coutu ; M.D.^g ; Megan Delisle ; M.D.^d ; Benoit Mesurolle ; M.D.^c ; ^e ; Sarkis Meterissian ; M.D. ; M.Sc. ; FRCS ; FACS^a ; ^c ; ^f ; ^{sarkis.meterissian@muhc.mcgill.ca" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Magnetic resonance imaging ; Breast cancer ; Mastectomy ; Conservation treatment ; Surgical decision making
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：211
• 期：6
• 页码：1089-1094
• 全文大小：187 K

文摘

Magnetic resonance imaging (MRI) is gaining popularity in the preoperative management of breast cancer patients. However, the role of this modality remains controversial. We aimed to study the impact of preoperative MRI (pMRI) on the surgical management of breast cancer patients.

Methods

This retrospective study included 766 subjects with breast cancer treated operatively at the specialized academic center.

Results

Between those who underwent pMRI (MRI group, n = 307) and those who did not (no-MRI group, n = 458), there were no significant differences (P = .254) in the proportions of either total mastectomies (20.5% vs 17.2%, respectively) or segmental mastectomies (79.5% vs 82.8%). Patients in the MRI group were significantly more likely (P = .002) to undergo contralateral surgery (11.7% vs 5.5%). Similar results were obtained in multivariate analysis adjusting for age, with the proportions of contralateral breast operations significantly higher in the MRI group (Odds Ratio = 2.25, P = .007). pMRI had no significant effect (P = .54) on the proportion of total re-excisions (7.5% vs 8.7%) or the type of re-excision (total vs segmental mastectomy) between the groups.

Conclusions

pMRI does not have a significant impact on the type of operative intervention on the ipsilateral breast but is associated with an increase in contralateral operations. Similarly, pMRI does not change the proportion of re-excisions or the type of the re-excision performed. This study demonstrates that pMRI has little impact on the surgical management of breast cancer, and its value as a routine adjunct in the preoperative work-up of recently diagnosed breast cancer patients needs to be re-examined.