ARRS: Breast MRI can benefit breast cancer screening, reduce local recurrence

According to the findings of two recent Italian studies presented at the American Roentgen Ray Society (ARRS) 2010 Annual Meeting in San Diego on May 5, breast MRI can detect lesions missed on mammography and ultrasound and help surgeons plan the most appropriate surgical treatment, and by using preoperative breast MRI prior to surgical intervention, the number of local cancer recurrences at follow-up can be reduced.

Valeria Dominelli, MD, of the University of Rome “La Sapienza” in Rome and colleagues explained that breast MRI is increasingly being used for the preoperative evaluation of patients with newly diagnosed breast cancer, as other imaging modalities cannot obtain the same information about many breast conditions. The researchers recruited 164 patients from the university with biopsy-proven breast cancer and analyzed how breast MRI influenced the surgical management choices of those patients. For 32 of the 164 patients, breast MRI altered the therapeutic plan previously proposed based on mammography and ultrasound, they said. In addition, Dominelli explained that 51 additional suspicious lesions not seen on mammography or ultrasound were detected by way of breast MRI.

“Breast MRI positively impacts patient management decisions and should be recommended for mapping tumor extent in patients with newly diagnosed breast cancer,” offered Dominelli. “The correct assessment of the disease can help the surgeon plan the most appropriate surgical treatment, possibly reducing the need for re-intervention.” In addition to tumor mapping in newly diagnosed cancer cases, Dominelli and colleagues from the university offered the findings of another study suggesting that by using breast MRI prior to any surgical intervention for the treatment of breast cancer, local and regional recurrences could potentially be reduced.

While the researchers noted that local and regional recurrences after breast-conserving surgery are rare, young age and breast density can place patients at a greater risk. For this study, Dominelli and colleagues selected 49 patients with a local recurrence that was detected after surgical treatment of the primary carcinoma at the university. Of the 49 patients, 10 had undergone contrast-enhanced MRI prior to surgery. Contralateral carcinoma, or cancer in the opposite breast, and local recurrence were seen significantly more in patients who did not receive an MRI examination prior to surgery, noted the researchers.

Based on the findings, Dominelli recommended the utilization of breast MRI in patients with breast cancer for a better evaluation of the extent of the disease. “Our study suggests that preoperative breast MRI staging allows for a significant reduction in the number of local cancer recurrences at follow-up,” she concluded.