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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2010

01-10-2010 | American Society of Breast Surgeons

Impact of Preoperative Breast MRIs on Timing of Surgery and Type of Intervention in Newly Diagnosed Breast Cancer Patients

Authors: Fernando A. Angarita, MD, Sergio A. Acuna, MD, Adriana Fonseca, MD, Pavel Crystal, MD, Jaime Escallon, MD, FRCS(C), FACS

Published in: Annals of Surgical Oncology | Special Issue 3/2010

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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.
Literature
1.
Dummin LJ, Cox M, Plant L. Prediction of breast tumor size by mammography and sonography—a breast screen experience. Breast. 2007;16:38–46.CrossRefPubMed
2.
Heusinger K, Lohberg C, Lux MP, et al. Assessment of breast cancer tumor size depends on method, histopathology and tumor size itself. Breast Cancer Res Treat. 2005;94:17–23.CrossRefPubMed
3.
Lagios MD, Westdahl PR, Rose MR. The concept and implications of multicentricity in breast carcinoma. Pathol annu. 1981;16(Pt 2):83–102.PubMed
4.
Holland R, Veling SHJ, Mravunc M, et al. Histologic multifocality of Tis, T1–2 breast carcinomas: implications for clinical trials of breast-conserving surgery. Cancer. 1985:56:979–90.CrossRefPubMed
5.
Vaidya JS, Vyas JJ, Chinoy RF, et al. Multicentricity of breast cancer: whole-organ analysis and clinical implications. Br J Cancer. 1996;74:820–4.PubMed
6.
Kurtz JM, Jacquemier J, Amatric R, et al. Breast conserving therapy for macroscopically multiple cancer. Ann Surg. 1990;212:38–44.CrossRefPubMed
7.
Wilson LD, Beinfield M, McKhan CF, et al. Conservative surgery and radiation in treatment of synchronous ipsilateral breast cancers. Cancer. 1993 72:137–42.CrossRefPubMed
8.
Esserman L, Hylton N, Yassa L, et al. Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging. J Clin Oncol. 1999;17:110–9.PubMed
9.
Fischer U, Zachariae O, Baum F, et al. The influence of preoperative MRI of the breasts on recurrence rate in patients with breast cancer. Eur Radiol. 2004;14:1725–31.PubMed
10.
Sardanelli F, Giuseppetti GM, Panizza P, et al. Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in fatty and dense breasts using the wholebreast pathologic examination as a gold standard. AJR Am J Roentgenol. 2004;183:1149–57.PubMed
11.
Deurloo E, Deterse JL, Rutgers E, et al. Additional breast lesions in patients eligible for breast-conserving therapy by MRI: impact on preoperative management and potential benefit of computerized analysis. Eur J Cancer. 2005;41:1393–401.CrossRefPubMed
12.
Fischer U, Baum F, Luftner-Nagel S. Preoperative MR imaging in patients with breast cancer: preoperative staging, effects on recurrence rates, and outcome analysis. Magn Reson Imaging Clin N Am. 2006;14:351–62.CrossRefPubMed
13.
Lehman CD, Gatsonis C, Kuhl CK, et al. MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med. 2007;356:1295–303.CrossRefPubMed
14.
Van Goethem M, Schelfout K, Dijckmans L, et al. MR mammography in the pre-operative staging of breast cancer in patients with dense breast tissue: comparison with mammography and ultrasound. Eur Radiol. 2004;14:809–16.CrossRefPubMed
15.
Tozaki M, Fukuma E, Kawano N, et al. Bilateral breast MR imaging: is it superior to conventional methods for the detection of contralateral breast cancer? Breast Cancer. 2008;15:169–74.CrossRefPubMed
16.
Houssami N, Ciatto S, Macaskill P, et al. Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer. J Clin Oncol. 2008;26:3248–58.CrossRefPubMed
17.
Liberman L, Morris EA, Kim CM, et al. MR imaging findings in the contralateral breast of women with recently diagnosed breast cancer. AJR Am J Roentgenl. 2003;180:333–41.
18.
Lee SG, Orel SG, Woo IJ, et al. MR imaging screening of the contralateral breast in patients with newly diagnosed breast cancer: preliminary results. Radiology. 2003;226:773–8.CrossRefPubMed
19.
20.
Bevers TB, Anderson BO, Bonaccio E, et al. NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis. J Natl Compr Canc Netw. 2009;7:1060–96.PubMed
21.
Bleicher RJ, Ciocca RM, Egleston BL, et al. Association of routine pretreatment magnetic resonance imaging with time to surgery, mastectomy rate, and margin status. J Am Coll Surg. 2009;209:180–7.CrossRefPubMed
22.
23.
24.
Lehman CD, DeMartini W, Anderson BO, et al. Indications for breast MRI in the patient with newly diagnosed breast cancer. J Natl Compr Canc Netw. 2009;792:193–201.
25.
Kuhl CK, Bieling HB, Gieseke J, et al. Healthy premenopausal breast parenchyma in dynamic contrastenhanced MR imaging of the breast: normal contrast medium enhancement and cyclical-phase dependency. Radiology. 1997;203:137–44.PubMed
26.
Muller-Schimpfle M, Ohmenhauser K, Stoll P, et al. Menstrual cycle and age: influence on parenchymal contrast medium enhancement in MR imaging of the breast. Radiology. 1997;203:145–9.PubMed
27.
Bedrosian I, Mick R, Orel SG, et al. Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer. 2003;98:468–73.CrossRefPubMed
28.
Sardanelli F. Overview of the role of pre-operative breast MRI in the absence of evidence on patient outcomes. Breast. 2010 Feb;19:3–6.CrossRefPubMed
29.
Krishnan M, Thorsteinsson D, Horowitz N, et al. The influence of preoperative MRI in the timing and type of therapy in women newly diagnosed with breast cancer. AJR Am J Roentgenol. 2008;190:A31–4.
30.
31.
Richards MA, Westcombe AM, Love SB, et al. Influence of delay on survival in patients with breast cancer: a systematic review. Lancet. 1999;353:1119–26.CrossRefPubMed
32.
Colbert K. The longer the delay, the greater the anxiety. Delay in treatment for breast cancer. Prof Nurse. 1994;9:517–20.PubMed
33.
Hollingsworth AB, Stough RG. Preoperative breast MRI for locoregional staging. J Okla State Med Assoc. 2006;99:505–15.PubMed
34.
Schnall MD, Blume J, Bluemke DA, et al. MRI detection of distinct incidental cancer in women with primary breast cancer studied in IBMC 6883. J Surg Oncol. 2005;92:32–8.CrossRefPubMed
35.
Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology. 1999;213:881–8.PubMed
36.
Lehman CD, Blume JD, Thickman D, et al. Added cancer yield of MRI in screening the contralateral breast of women recently diagnosed with breast cancer: results from the International Breast Magnetic Resonance Consortium (IBMC) trial. J Surg Oncol. 2005;92:9–15.CrossRefPubMed
37.
Morrow M. Magnetic resonance imaging in the preoperative evaluation of breast cancer: primum non nocere. J Am Coll Surg. 2004;198:240–1.CrossRefPubMed
38.
Turnbull L, Brown S, Harvey I, et al. Comparative Effectiveness of MRI in Breast Cancer (COMICE) trial: a randomised controlled trial. Lancet. 2010;375:528–30.CrossRef
39.
Clemons M, Danson S, Hamilton T, et al. Locoregionally recurrent breast cancer: incidence, risk factors and survival. Cancer Treat Rev. 2001;27:67–82.CrossRefPubMed
40.
Punglia R, Morrow M, Winer E, et al. Local therapy and survival in breast cancer. N Engl J Med. 2007;356:2399–405.CrossRefPubMed
41.
Liberman L, Morris EA, Dershaw DD, et al. MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. AJR Am J Roentgenol. 2003;180:901–10.PubMed
42.
Lim HI, Choi JH, Yan JH, et al. Does pre-operative breast magnetic resonance imaging in addition to mammography and breast ultrasonography change the operative management of breast carcinoma? Breast Cancer Res Treat. 2010;119:163–7.CrossRefPubMed
43.
Bilimoria KY, Cambic A, Hansen NM, et al. Evaluating the impact of preoperative breast magnetic resonance imaging on the surgical management of newly diagnosed breast cancers. Arch Surg. 2007;142:441–5.CrossRefPubMed
44.
Berg WA, Gutierrez L, NessAiver MS, et al. Diagnostic accuracy of mammography, linical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology. 2004;233:830–49.CrossRefPubMed
45.
Bagley FH. The role of magnetic resonance imaging mammography in the surgical management of the index breast cancer. Arch Surg. 2004;139:380–3.CrossRefPubMed
46.
Zhang Y, Fukatsu H, Naganawa S, et al. The role of contrast-enhanced MR mammography for determining candidates for breast conservation surgery. Breast Cancer. 2002;9:231–9.CrossRefPubMed
47.
Orel SG, Schnall MD, Powell CM, et al. Staging of suspected breast cancer: effect of MR imaging and MR-guided biopsy. Radiology. 1995;196:115–22.PubMed
Metadata
Title
Impact of Preoperative Breast MRIs on Timing of Surgery and Type of Intervention in Newly Diagnosed Breast Cancer Patients
Authors
Fernando A. Angarita, MD
Sergio A. Acuna, MD
Adriana Fonseca, MD
Pavel Crystal, MD
Jaime Escallon, MD, FRCS(C), FACS
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1239-1

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