JACS: MRI may be unnecessary prior to treatment for new breast cancers
Research published in the August issue of the Journal of the American College of Surgeons challenges the routine use of MRI as a means to improve surgical outcomes in newly diagnosed breast cancer patients. Investigators found that women diagnosed with breast cancer who received an MRI were more likely to undergo a mastectomy than breast conserving therapy (BCT), and may face delays in treatment.
Although there is sufficient evidence that MRI is a beneficial screening tool in women with a high risk of developing breast cancer, prospective data demonstrating the benefits of MRI in the evaluation of newly diagnosed patients are lacking, the authors wrote.
"Our study does not support the routine use of MRI to evaluate breast cancer, yet we found that more and more women with newly diagnosed breast cancer are getting these scans," said Richard J. Bleicher, MD, a surgical oncologist at Fox Chase Cancer Center in Philadelphia. "Although MRI can be of benefit in the detection of cancer because of its sensitivity, it has a well-documented false-positive rate that may be misleading women to choose mastectomies when instead they could have breast conserving therapy."
A multidisciplinary team retrospectively reviewed and evaluated records of patients diagnosed with breast cancer before referral to Fox Chase from July 2004 to December 2006 by including radiologists, surgeons, radiation oncologists, and medical oncologists.
Of the 577 patients reviewed, the researchers found that 22.5 percent had an MRI prior to treatment. When performed, the MRIs were obtained before referral in 94.6 percent of patients.
The study showed that MRI scans in women with newly diagnosed breast cancer increased from 13 percent in 2004 to 27 percent in 2006, according to the researchers.
Most notably, Bleicher and colleagues observed that patients who received an MRI were significantly more likely to undergo mastectomy as the initial surgery compared to BCT.
Furthermore, women who received an MRI experienced an average delay of 22.4 days—from the initial symptom or abnormal imaging study—jn receiving treatment evaluation, according to the authors. There was no statistically significant difference between groups in either the ability to achieve complete removal of malignant cells with a single excision or the rate of unplanned mastectomy after BCT.
Although there is sufficient evidence that MRI is a beneficial screening tool in women with a high risk of developing breast cancer, prospective data demonstrating the benefits of MRI in the evaluation of newly diagnosed patients are lacking, the authors wrote.
"Our study does not support the routine use of MRI to evaluate breast cancer, yet we found that more and more women with newly diagnosed breast cancer are getting these scans," said Richard J. Bleicher, MD, a surgical oncologist at Fox Chase Cancer Center in Philadelphia. "Although MRI can be of benefit in the detection of cancer because of its sensitivity, it has a well-documented false-positive rate that may be misleading women to choose mastectomies when instead they could have breast conserving therapy."
A multidisciplinary team retrospectively reviewed and evaluated records of patients diagnosed with breast cancer before referral to Fox Chase from July 2004 to December 2006 by including radiologists, surgeons, radiation oncologists, and medical oncologists.
Of the 577 patients reviewed, the researchers found that 22.5 percent had an MRI prior to treatment. When performed, the MRIs were obtained before referral in 94.6 percent of patients.
The study showed that MRI scans in women with newly diagnosed breast cancer increased from 13 percent in 2004 to 27 percent in 2006, according to the researchers.
Most notably, Bleicher and colleagues observed that patients who received an MRI were significantly more likely to undergo mastectomy as the initial surgery compared to BCT.
Furthermore, women who received an MRI experienced an average delay of 22.4 days—from the initial symptom or abnormal imaging study—jn receiving treatment evaluation, according to the authors. There was no statistically significant difference between groups in either the ability to achieve complete removal of malignant cells with a single excision or the rate of unplanned mastectomy after BCT.