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01.07.2009 | Clinical Trial

The impact of preoperative MRI on breast-conserving surgery of invasive cancer: a comparative cohort study

verfasst von: K. E. Pengel, C. E. Loo, H. J. Teertstra, S. H. Muller, J. Wesseling, J. L. Peterse, H. Bartelink, E. J. Rutgers, K. G. A. Gilhuijs

Erschienen in: Breast Cancer Research and Treatment | Ausgabe 1/2009

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Abstract

Aim To assess whether preoperative contrast-enhanced magnetic resonance imaging (MRI) of the breast influences the rate of incomplete tumor excision. Methods In a cohort of 349 women with invasive breast cancer, patients eligible for breast-conserving therapy (BCT) on the basis of conventional imaging and palpation only (N = 176) were compared to those who had an additional preoperative MRI (N = 173). Multivariate analysis was applied to explore associations with incomplete tumor excision. Results MRI detected larger extent of breast cancer in 19 women (11.0%), leading to treatment change: mastectomy (8.7%) or wider excision (2.3%). Tumor excision was incomplete in 22/159 (13.8%) wide local excisions in the MRI group and in 35/180 (19.4%) in the non-MRI group (P = 0.17). Stratified to tumor type, incompletely excised infiltrating ductal carcinoma (IDC) was significantly associated with absence of MRI: 11/136 (8.1%) versus 2/126 (1.6%) (MRI present) (P = 0.02). No significant factors explained incomplete excision of other tumor types. Conclusion Preoperative MRI did not significantly affect the overall rate of incomplete tumor excision, but it yielded significantly lower rate of incompletely excised IDC. The reduction of incomplete excisions after MRI was smaller than the rate of a prior treatment change incurred by MRI.

van Dongen JA et al (2000) 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 92:1143–1150PubMedCrossRef

Clarke M et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366:2087–2106PubMed

Bartelink H et al (2001) Recurrence rates after treatment of breast cancer with standard radiotherapy with or without additional radiation. N Engl J Med 345:1378–1387PubMedCrossRef

Vrieling C et al (2003) Can patient-, treatment- and pathology-related characteristics explain the high local recurrence rate following breast-conserving therapy in young patients? Eur J Cancer 39:932–944PubMedCrossRef

Kreike B et al (2008) Continuing risk of ipsilateral breast relapse after breast-conserving therapy at long-term follow-up. Int J Radiat Oncol Biol Phys 71:1014–1021PubMed

Smitt MC et al (1995) The importance of the lumpectomy surgical margin status in long-term results of breast conservation. Cancer 76:259–267PubMedCrossRef

Faverly DR, Hendriks JH, Holland R (2001) Breast carcinomas of limited extent: frequency, radiologic-pathologic characteristics, and surgical margin requirements. Cancer 91:647–659PubMedCrossRef

Boetes C et al (1995) Breast tumors: comparative accuracy of MR imaging relative to mammography and US for demonstrating extent. Radiology 197:743–747PubMed

Hata T et al (2004) Magnetic resonance imaging for preoperative evaluation of breast cancer: a comparative study with mammography and ultrasonography. J Am Coll Surg 198:190–197PubMedCrossRef

10.

Berg WA et al (2004) Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology 233:830–849PubMedCrossRef

11.

Deurloo EE et al (2006) Contrast-enhanced MRI in breast cancer patients eligible for breast-conserving therapy: complementary value for subgroups of patients. Eur Radiol 16:692–701PubMedCrossRef

12.

Deurloo EE et al (2005) Additional breast lesions in patients eligible for breast-conserving therapy by MRI: impact on preoperative management and potential benefit of computerised analysis. Eur J Cancer 41:1393–1401PubMedCrossRef

13.

Braun M et al (2008) Influence of preoperative MRI on the surgical management of patients with operable breast cancer. Breast Cancer Res Treat 111:179–187PubMedCrossRef

14.

Bilimoria KY et al (2007) Evaluating the impact of preoperative breast magnetic resonance imaging on the surgical management of newly diagnosed breast cancers. Arch Surg 142:441–445PubMedCrossRef

15.

Grobmyer SR et al (2008) Is there a role for routine use of MRI in selection of patients for breast-conserving cancer therapy? J Am Coll Surg 206:1045–1050PubMedCrossRef

16.

Bedrosian I et al (2003) Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer 98:468–473PubMedCrossRef

17.

Houssami N et al (2008) 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 26:3248–3258PubMedCrossRef

18.

Plevritis SK, Ikeda DM (2002) Ethical issues in contrast-enhanced magnetic resonance imaging screening for breast cancer. Top Magn Reson Imaging 13:79–84PubMedCrossRef

19.

Morrow M (2004) Magnetic resonance imaging in the preoperative evaluation of breast cancer: primum non nocere. J Am Coll Surg 198:240–241PubMedCrossRef

20.

Morrow M (2008) Magnetic resonance imaging in the breast cancer patient: curb your enthusiasm. J Clin Oncol 26:352–353PubMedCrossRef

21.

Heywang-Kobrunner SH et al (1997) Contrast-enhanced MRI of the breast: accuracy, value, controversies, solutions. Eur J Radiol 24:94–108PubMedCrossRef

22.

Bleicher RJ, Morrow M (2007) MRI and breast cancer: role in detection, diagnosis, and staging. Oncology 21:1521–1528, 1530PubMed

23.

Orel S (2008) Who should have breast magnetic resonance imaging evaluation? J Clin Oncol 26:703–711PubMedCrossRef

24.

van Rijk MC et al (2006) Ultrasonography and fine-needle aspiration cytology can spare breast cancer patients unnecessary sentinel lymph node biopsy. Ann Surg Oncol 13:31–35PubMedCrossRef

25.

Rutgers EJ (2001) Quality control in the locoregional treatment of breast cancer. Eur J Cancer 37:447–453PubMedCrossRef

26.

Rutgers EJ (2004) Sentinel node procedure in breast carcinoma: a valid tool to omit unnecessary axillary treatment or even more? Eur J Cancer 40:182–186PubMedCrossRef

27.

van Rijk MC et al (2007) Sentinel node biopsy and concomitant probe-guided tumor excision of nonpalpable breast cancer. Ann Surg Oncol 14:627–632PubMedCrossRef

28.

Aspegren K, Holmberg L, Adami HO (1988) Standardization of the surgical technique in breast-conserving treatment of mammary cancer. Br J Surg 75:807–810PubMedCrossRef

29.

Egan RL (1982) Multicentric breast carcinomas: clinical-radiographic-pathologic whole organ studies and 10-year survival. Cancer 49:1123–1130PubMedCrossRef

30.

Bloom HJ, Richardson WW (1957) Histological grading and prognosis in breast cancer; a study of 1409 cases of which 359 have been followed for 15 years. Br J Cancer 11:359–377PubMed

31.

Elston CW, Ellis IO (1991) Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology 19:403–410PubMedCrossRef

32.

Holland R et al (1985) Histologic multifocality of Tis, T1–2 breast carcinomas. Implications for clinical trials of breast-conserving surgery. Cancer 56:979–990PubMedCrossRef

33.

Rosen PP et al (1975) “Residual” mammary carcinoma following simulated partial mastectomy. Cancer 35:739–747PubMedCrossRef

34.

Anastassiades O et al (1993) Multicentricity in breast cancer. A study of 366 cases. Am J Clin Pathol 99:238–243PubMed

35.

Coombs NJ, Boyages J (2005) Multifocal and multicentric breast cancer: does each focus matter? J Clin Oncol 23:7497–7502PubMedCrossRef

36.

Fischer U et al (2004) The influence of preoperative MRI of the breasts on recurrence rate in patients with breast cancer. Eur Radiol 14:1725–1731PubMed

37.

Solin LJ et al (2008) 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 26:386–391PubMedCrossRef

38.

Kneeshaw PJ, Turnbull LW, Drew PJ (2003) Current applications and future direction of MR mammography. Br J Cancer 88:4–10PubMedCrossRef

39.

Mann RM et al (2008) The value of MRI compared to mammography in the assessment of tumour extent in invasive lobular carcinoma of the breast. Eur J Surg Oncol 34:135–142PubMed

40.

Boetes C et al (2004) The role of MRI in invasive lobular carcinoma. Breast Cancer Res Treat 86:31–37PubMedCrossRef

41.

Quan ML et al (2003) Magnetic resonance imaging detects unsuspected disease in patients with invasive lobular cancer. Ann Surg Oncol 10:1048–1053PubMedCrossRef

42.

Rodenko GN et al (1996) MR imaging in the management before surgery of lobular carcinoma of the breast: correlation with pathology. AJR Am J Roentgenol 167:1415–1419PubMed

43.

Weinstein SP et al (2001) MR imaging of the breast in patients with invasive lobular carcinoma. AJR Am J Roentgenol 176:399–406PubMed

44.

Mann RM et al (2008) MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature. Breast Cancer Res Treat 107:1–14PubMedCrossRef

45.

Krecke KN, Gisvold JJ (1993) Invasive lobular carcinoma of the breast: mammographic findings and extent of disease at diagnosis in 184 patients. AJR Am J Roentgenol 161:957–960PubMed

46.

Arpino G et al (2004) Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res 6:R149–R156PubMedCrossRef

47.

Bluemke DA et al (2004) Magnetic resonance imaging of the breast prior to biopsy. JAMA 292:2735–2742PubMedCrossRef

48.

Kuhl CK et al (2007) MRI for diagnosis of pure ductal carcinoma in situ: a prospective observational study. Lancet 370:485–492PubMedCrossRef

49.

Santamaria G et al (2008) Preoperative MRI of pure intraductal breast carcinoma—a valuable adjunct to mammography in assessing cancer extent. Breast 17:186–194PubMedCrossRef

50.

Rosen EL et al (2007) BI-RADS MRI enhancement characteristics of ductal carcinoma in situ. Breast J 13:545–550PubMedCrossRef

51.

Peters NH et al (2007) Breast MRI in nonpalpable breast lesions: a randomized trial with diagnostic and therapeutic outcome—MO. Trials 8:40PubMedCrossRef

Titel: The impact of preoperative MRI on breast-conserving surgery of invasive cancer: a comparative cohort study
verfasst von: K. E. Pengel
C. E. Loo
H. J. Teertstra
S. H. Muller
J. Wesseling
J. L. Peterse
H. Bartelink
E. J. Rutgers
K. G. A. Gilhuijs
Publikationsdatum: 01.07.2009
Verlag: Springer US
Erschienen in: Breast Cancer Research and Treatment / Ausgabe 1/2009
Print ISSN: 0167-6806
Elektronische ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-008-0182-3

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