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The case against routine preoperative breast MRI

    Ismail Jatoi

    * Author for correspondence

    Division of Surgical Oncology, MC 7738, University of Texas Health Sciences Center, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA.

    &
    John R Benson

    Cambridge Breast Unit, Addenbrookes Hospital, Cambridge University, Cambridge, UK

    Published Online:https://doi.org/10.2217/fon.12.186

    In patients with primary breast cancer, preoperative MRI identifies additional foci of tumor in the ipsilateral or contralateral breast that are not evident with standard imaging. Breast cancer patients who are otherwise deemed suitable candidates for breast-conserving surgery might, therefore, be urged to undergo mastectomy or even bilateral mastectomy following staging with preoperative breast MRI. The effect of preoperative breast MRI on clinical end points (rates of ipsilateral breast tumor recurrence) and surgical end points (rates of reoperation) have been assessed in several large studies. These studies indicate that the routine use of preoperative breast MRI is not beneficial. The additional occult foci of tumor detected with preoperative breast MRI seem to either have no clinical significance, or can be adequately treated with radiotherapy and/or systemic therapy. This article reviews these studies and highlights the potential harms associated with the routine use of preoperative MRI in patients with primary breast cancer.

    Papers of special note have been highlighted as: ▪ of interest ▪▪ of considerable interest

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