Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA)

Medientyp: E-Artikel
Titel: Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA)
Beteiligte: Sardanelli, Francesco; Trimboli, Rubina M.; Houssami, Nehmat; Gilbert, Fiona J.; Helbich, Thomas H.; Álvarez Benito, Marina; Balleyguier, Corinne; Bazzocchi, Massimo; Bult, Peter; Calabrese, Massimo; Camps Herrero, Julia; Cartia, Francesco; Cassano, Enrico; Clauser, Paola; Cozzi, Andrea; de Andrade, Danúbia A.; de Lima Docema, Marcos F.; Depretto, Catherine; Dominelli, Valeria; Forrai, Gábor; Girometti, Rossano; Harms, Steven E.; Hilborne, Sarah; Ienzi, Raffaele; [...]
Erschienen: Springer Science and Business Media LLC, 2022
Erschienen in: European Radiology
Sprache: Englisch
DOI: 10.1007/s00330-021-08240-x
ISSN: 0938-7994; 1432-1084
Schlagwörter: Radiology, Nuclear Medicine and imaging ; General Medicine
Entstehung:
Anmerkungen:
Beschreibung: <jats:title>Abstract</jats:title><jats:sec> <jats:title>Objectives</jats:title> <jats:p>Preoperative breast magnetic resonance imaging (MRI) can inform surgical planning but might cause overtreatment by increasing the mastectomy rate. The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue.</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>This observational study enrolled women aged 18–80 years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers. Exclusion criteria included planned neoadjuvant therapy, pregnancy, personal history of any cancer, and distant metastases.</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>Of 5896 analyzed patients, 2763 (46.9%) had conventional imaging only (noMRI group), and 3133 (53.1%) underwent MRI that was performed for diagnosis, screening, or unknown purposes in 692/3133 women (22.1%), with preoperative intent in 2441/3133 women (77.9%, MRI group). Patients in the MRI group were younger, had denser breasts, more cancers ≥ 20 mm, and a higher rate of invasive lobular histology than patients who underwent conventional imaging alone (<jats:italic>p</jats:italic> < 0.001 for all comparisons). Mastectomy was planned based on conventional imaging in 22.4% (MRI group) versus 14.4% (noMRI group) (<jats:italic>p</jats:italic> < 0.001). The additional planned mastectomy rate in the MRI group was 11.3%. The overall performed first- plus second-line mastectomy rate was 36.3% (MRI group) versus 18.0% (noMRI group) (<jats:italic>p</jats:italic> < 0.001). In women receiving conserving surgery, MRI group had a significantly lower reoperation rate (8.5% versus 11.7%, <jats:italic>p</jats:italic> < 0.001).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Clinicians requested breast MRI for women with a higher a priori probability of receiving mastectomy. MRI was associated with 11.3% more mastectomies, and with 3.2% fewer reoperations in the breast conservation subgroup.</jats:p> </jats:sec><jats:sec> <jats:title>Key Points</jats:title> <jats:p><jats:italic>• In 19% of patients of the MIPA study, breast MRI was performed for screening or diagnostic purposes.</jats:italic></jats:p> <jats:p><jats:italic>• The current patient selection to preoperative breast MRI implies an 11% increase in mastectomies, counterbalanced by a 3% reduction of the reoperation rate.</jats:italic></jats:p> <jats:p><jats:italic>• Data from the MIPA study can support discussion in tumor boards when preoperative MRI is under consideration and should be shared with patients to achieve informed decision-making.</jats:italic></jats:p> </jats:sec>

Nur in Feld suchen:

Zuletzt gesuchte Begriffe: