Impact of preoperative breast MRIs on timing of surgery and type of intervention in newly diagnosed breast cancer patients

Ann Surg Oncol. 2010 Oct:17 Suppl 3:273-9. doi: 10.1245/s10434-010-1239-1. Epub 2010 Sep 19.

Abstract

Background: We sought to evaluate the effect of preoperative breast magnetic resonance imaging (BMRI) on the wait time to surgery and to what extent it affects the surgical management plan initially considered.

Methods: From April 2007 to April 2009, a total of 147 newly diagnosed breast cancer patients who underwent surgery as initial treatment at Marvelle Koffler Breast Centre at Mount Sinai Hospital, Toronto, Ontario, Canada, met the inclusion criteria and were divided into two groups: those who had BMRI (n =71) and those who did not (n = 76). Time to surgery was calculated from the day core biopsy result was available to the date surgery was carried out. Time span between initial surgical consult and the day of the surgery day was also calculated. Change was defined as conversion from conservative to radical surgery and/or unilateral to bilateral procedures.

Results: Overall waiting period between histologic diagnosis and treatment was 34.2 days (BMRI group 36.0 days vs. non-BMRI group 32.3 days, P =0.15); and between date surgical management was propose and date of surgery (BMRI group 24.2 days vs. non-BMRI group 22.5 days, P =0.38). Additional workup resulted in seven otherwise occult malignant lesions that required change. Ten percent of patients who underwent BMRI had change in surgical management. The mastectomy rate was higher among those with preoperative BMRI (initial 12% vs. final 26%, P =0.8), but this was not statistically significant.

Conclusions: Preoperative BMRI did not delay surgical treatment or correlate with a higher rate of radical treatment.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / surgery
  • Carcinoma, Ductal, Breast / diagnosis*
  • Carcinoma, Ductal, Breast / surgery
  • Carcinoma, Intraductal, Noninfiltrating / diagnosis*
  • Carcinoma, Intraductal, Noninfiltrating / surgery
  • Carcinoma, Lobular / diagnosis*
  • Carcinoma, Lobular / surgery
  • Cohort Studies
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Mastectomy*
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Preoperative Care
  • Prognosis
  • Retrospective Studies
  • Time Factors