Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2011

01-06-2011 | Breast Oncology

Patient Age and Preoperative Breast MRI in Women With Breast Cancer: Biopsy and Surgical Implications

Authors: Cameron D. Adkisson, MD, Laura A. Vallow, MD, Kristin Kowalchik, MD, Rebecca McNeil, PhD, Stephanie Hines, MD, Elizabeth Deperi, MD, Alvaro Moreno, MD, Vivek Roy, MD, Edith A. Perez, MD, Sarah A. McLaughlin, MD

Published in: Annals of Surgical Oncology | Issue 6/2011

Login to get access

Abstract

Background

The influence of patient age on multidisciplinary treatment planning after preoperative breast magnetic resonance imaging (MRI) and its influence on the surgical decision-making process are unclear.

Methods

We performed a retrospective review of 710 women with breast cancer who underwent preoperative MRI at our institution between January 2003 and December 2008. Analysis by patient age included the number of additional ipsilateral MRI findings, the number of biopsies recommended/performed, the number of additional cancers found, and the percentage of patients undergoing mastectomy.

Results

Of the 710 patients, 343 (48%) had additional ipsilateral MRI findings. After stratifying by age, the incidence of additional ipsilateral findings differed between decades (P = 0.004). However, fewer biopsies were recommended in older patients (P = 0.043). The number of women pursuing preoperative needle biopsy increased with age (P = 0.0018), while the incidence of a second focus of breast cancer did not change with age (P = 0.07). The mastectomy rate decreased from 65% in women younger than 50 to 40% in women older than 70 (P < 0.001).

Conclusions

In the setting of newly diagnosed breast cancer, the value of MRI is not influenced by patient age, with at least 40% of women in all age groups having additional findings on MRI. Insisting on preoperative needle biopsy of additional findings may decrease mastectomy rates. Further study is needed to determine the reasons for the increased percentage of mastectomies in younger women.
Literature
1.
Veronesi U, Cascinella N, Mariani L, et al. Twenty year follow up of a randomized study comparing breast conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32.PubMedCrossRef
2.
Bilchert-Toft M, Rose C, Anderson J, et al. Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life table analysis: Danish Breast Cancer Cooperative Group. J Natl Cancer Inst Monogr. 1992;19–25.
3.
Lichter AS, Lippman ME, Danforth DN, et al. Mastectomy versus breast conserving therapy in the treatment of stage I and stage II carcinoma of the breast: a randomized trial at the National Cancer Institute. J Clin Oncol. 1992;10:976–83.PubMed
4.
Van Dongen JA, Voogd AC, Fentiman IS, et al. Long term results of a randomized trial comparing breast conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial. J Natl Cancer Inst. 2000;92:1143–50.PubMedCrossRef
5.
Fisher B, Anderson S, Bryant J, et al. Twenty year follow up of a randomized trial comparing mastectomy, lumpectomy and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med. 2002;347:1233–41.PubMedCrossRef
6.
Poggi M, Danforth D, Sciuto L, et al. Eighteen year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy. Cancer. 2003;98:697–702.PubMedCrossRef
7.
Du X, Freeman D Jr, Syblik D. What drove changes in the use of breast conserving surgery since the early 1980’s? The role of the clinical trial, celebrite action and an NIH consensus statement. Breast Cancer Res Treat. 2000;62:71–9.PubMedCrossRef
8.
Lazovich D, Solomon C, Thomas D, et al. Breast conservation therapy in the United States following the 1990 National Institutes of Health Consensus Development Conference on the treatment of patients with early stage invasive breast carcinoma. Cancer. 1999;86:628–37.PubMedCrossRef
9.
McGuire KP, Santillan AA, Kaur P, et al. Are mastectomies on the rise? A 13 year trend analysis of the selection of mastectomy versus breast conservation therapy in 5865 patients. Ann Surg Oncol. 2009;16:2682–90.PubMedCrossRef
10.
Katipamula R, Degnim A, Hoskin TL, et al. Trends in mastectomy rates at the Mayo Clinic Rochester: effect of surgical year and preoperative magnetic resonance imaging. J Clin Oncol. 2009;27:4082–8.PubMedCrossRef
11.
Bagley F. The role of magnetic resonance imaging mammography in the surgical management of the index breast cancer. Arch Surg. 2004;139:380–3.PubMedCrossRef
12.
Bilimora K, Cambic A, Hansen N, Bethke K. Evaluating the impact of preoperative breast magnetic resonance imaging on the surgical management of newly diagnosed breast cancers. Arch Surg. 2007;142:441–7.CrossRef
13.
Bedrosian I, Mick R, Orel S, et al. Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer. 2003;98:468–73.PubMedCrossRef
14.
Saslow D, Boetes C, Burke W, et al. American Cancer Society guidelines of breast screening with MRI as an adjunct to mammography. CA Cancer J Clin. 2007;57:75–89.PubMedCrossRef
15.
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
16.
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
17.
Liberman L, Morris EA, Dershaw DD, et al. MR imaging of the ipsilateral breast in women with percutaneously proven breast cancer. Am J Roentgenol. 2003;180:901–10.
18.
Mumtaz H, Hall-Craggs MA, Davidson T, et al. Staging of symptomatic primary breast cancer with MR imaging. Am J Roentgenol. 1997;169:417–24.
19.
Turnbull L, Brown S, Harvey I, Olivier C, et al. Comparative Effectiveness of MRI in Breast Cancer (COMICE) trial: a randomized controlled trial. Lancet. 2010;375(9714):563–71.PubMedCrossRef
20.
Bleicher RJ, Ciocca RM, Egleston BL, et al. The association of routine pretreatment magnetic resonance imaging with time to surgery, mastectomy rate, and margin status. J Am Coll Surg. 2009;209:180–7.PubMedCrossRef
21.
Solin L, Orel S, Hwang W, Harris E, et al. Relationship of breast magnetic resonance imaging to outcome after breast conservation treatment with radiation for women with early-stage invasive breast carcinoma or ductal carcinoma in situ. J Clin Oncol. 2008;26:386–91.PubMedCrossRef
22.
Carpenter S, Stucky C, Dueck A, et al. Scientific presentation award: the impact of magnetic resonance imaging on surgical treatment of invasive breast cancer. Am J Surg. 2009;198:475–81.PubMedCrossRef
23.
Dang C, Zaghiyan K, Karlan S, Phillips E. Increased use of MRI for breast cancer surveillance and staging is not associated with increased rate of mastectomy. Am Surg. 2009;75:937–40.PubMed
24.
Crowe J, Patrick R, Rim A. The importance of preoperative breast MRI for patients newly diagnosed with breast cancer. Breast J. 2009;15:52–60.PubMedCrossRef
25.
Furman B, Gardner M, Romilly P, et al. Effect of 0.5 Tesla magnetic resonance imaging on the surgical management of breast cancer patients. Am J Surg. 2003;186:344–7.PubMedCrossRef
26.
Pediconi F, Catalano C, Padula S, et al. Contrast-enhanced magnetic resonance mammography: does it affect surgical decision-making in patients with breast cancer? Breast Cancer Res Treat. 2007;106:65–74.PubMedCrossRef
27.
Pettit K, Swatske M, Gao F, et al. The impact of breast MRI on surgical decision-making: are patients at risk for mastectomy? J Surg Oncol. 2009;100:553–8.PubMedCrossRef
28.
McLaughlin S, Stempel M, Morris E, et al. Can magnetic resonance imaging be used to select patients for sentinel lymph node biopsy in prophylactic mastectomy? Cancer. 2008;112:1214–21.PubMedCrossRef
29.
Arrington A, Jarosek S, Virnig B, et al. Patient and surgeon characteristics associated with increased use of contralateral prophylactic mastectomy in patients with breast cancer. Ann Surg Oncol. 2009;16:2697–704.PubMedCrossRef
30.
Coutant C, Olivier C, Lambaudie E, et al. Comparison of models to predict nonsentinel lymph node status in breast cancer patients with metastatic sentinel lymph nodes: a prospective multicenter study. J Clin Oncol. 2009;272800–8.
Metadata
Title
Patient Age and Preoperative Breast MRI in Women With Breast Cancer: Biopsy and Surgical Implications
Authors
Cameron D. Adkisson, MD
Laura A. Vallow, MD
Kristin Kowalchik, MD
Rebecca McNeil, PhD
Stephanie Hines, MD
Elizabeth Deperi, MD
Alvaro Moreno, MD
Vivek Roy, MD
Edith A. Perez, MD
Sarah A. McLaughlin, MD
Publication date
01-06-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 6/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1491-4

Other articles of this Issue 6/2011

Annals of Surgical Oncology 6/2011 Go to the issue

Breast Oncology

The Effect of Hospital Volume on the Outcome of Breast Cancer Surgery

Hepatobiliary Tumors

Medium-Sized (3.1–5.0 cm) Hepatocellular Carcinoma: Transarterial Chemoembolization Plus Radiofrequency Ablation Versus Radiofrequency Ablation Alone

Breast Oncology

Has Placement of Surgical Clips in the Lumpectomy Bed Fallen Out of Favor?

Colorectal Cancer

Surgical Cytoreduction and Survival in Appendiceal Cancer Peritoneal Carcinomatosis: An Evaluation of 46 Consecutive Patients

Hepatobiliary Tumors

Improved Diagnostic Imaging and Interventional Therapies Prolong Survival After Resection for Hepatocellular Carcinoma in Cirrhosis: The University of Bologna Experience Over 10 Years

Colorectal Cancer

Peritoneal Carcinomatosis from Appendiceal Cancer: Early Adequate Therapeutic Management for Long-Term Survival