Preoperative Breast MRI Can Reduce the Rate of Tumor-Positive Resection Margins and Reoperations in Patients Undergoing Breast-Conserving Surgery

• Published in: American journal of roentgenology (1976) Vol. 200; no. 2; pp. 304 - 310
• Main Authors: Obdeijn, Inge-Marie, Tilanus-Linthorst, Madeleine M. A., Spronk, Sandra, van Deurzen, Carolien H. M., Monye, Cécile de, Hunink, M. G. Myriam, Menke, Marian B. E.
• Format: Journal Article
• Language: English
• Published: United States 01.02.2013
• Subjects: Adult; Aged; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Carcinoma in Situ - pathology; Carcinoma in Situ - surgery; Carcinoma, Ductal, Breast - pathology; Carcinoma, Ductal, Breast - surgery; Contrast Media; Female; Humans; Logistic Models; Magnetic Resonance Imaging - methods; Mastectomy, Segmental; Middle Aged; Organometallic Compounds; Preoperative Care; Reoperation; Statistics, Nonparametric; Subtraction Technique; Treatment Outcome
• ISSN: 0361-803X; 1546-3141; 1546-3141
• DOI: 10.2214/AJR.12.9185

In breast cancer patients eligible for breast-conserving surgery, we evaluated whether the information provided by preoperative MRI of the breast would result in fewer tumor-positive resection margins and fewer reoperations. The study group consisted of 123 consecutive patients diagnosed with either breast cancer or ductal carcinoma in situ eligible for breast-conserving surgery between April 2007 and July 2010. For these patients, a first plan for breast-conserving surgery was made on the basis of clinical examination and conventional imaging. The final surgical plan was made with knowledge of the preoperative breast MRI. The rates of tumor-positive resection margins and reoperations were compared with those of a historical control group consisting of 119 patients who underwent 123 breast-conserving procedures between January 2005 and December 2006. The percentage of change in the surgical plan was recorded. Preoperative breast MRI changed the surgical plan to more extensive surgery in 42 patients (34.1%), mainly to mastectomy (29 patients, 23.6%). Ninety-four patients underwent 95 breast-conserving procedures. Significantly fewer patients had tumor-positive resection margins than in the control group (15.8%, 15/95 versus 29.3%, 36/123; p < 0.01). Patients in the study group underwent significantly fewer reoperations compared with the historical control group (18.9%, 18/95 vs 37.4%, 46/123; p < 0.01). Preoperative breast MRI can substantially decrease the rate of tumor-positive resection margins and reoperations in breast cancer patients eligible for breast-conserving surgery.