Introduction
Methods
Structured question and outcome prioritisation
Population | Intervention | Comparison | Outcomes |
Women with confirmed DCIS on preoperative histology | Preoperative breast MRI | No preoperative breast MRI | • MRI triggered treatment change, as the decision to perform a wider excision, a mastectomy or a bilateral mastectomy when a more conservative approach were originally planned before MRI results • Initial breast-conserving surgery (BCS), a patient not undergoing mastectomy within the initial surgical treatmenta • Re-operation after breast-conserving surgery, either a wider local excision or mastectomy after the first surgery • Proportion of positive margins after breast-conserving surgery, absence of clear margins at the pathologic assessment of the specimen after surgical resection • Total mastectomy, the last definitive mastectomy, including initial and additional mastectomy due to re-operation • Disease-free survival (inferred from loco-regional recurrence) • Quality of life |
Data sources and searches
Study selection
Data extraction and risk of bias assessment
Data analysis
Certainty of the evidence
Results
Search results
Study characteristics
Author and year (trial) | Country | Design | No. of patients (only DCIS) | Tumour characteristics (microcalcification, size) | Age (years), mean (range) | Intervention (MRI) |
---|---|---|---|---|---|---|
Balleyguier (IRCIS) 2019 [21] | France | RCT | MRI: 176 No MRI: 173 | Microcalcification: MRI: 98%; No MRI: 99% Mean size (mm): MRI: 10, no MRI: 13 | MRI: 56 (31-80) No MRI: 58 (39–80) | 1.5 T systems mainly and 3 T systems in 2 centres |
Peters (MONET) 2011 [19] | Netherlands | RCT (subgroup analysis) | MRI: 39 No MRI: 41 | Microcalcification: NR Mean size (mm): NR | NR | 3 T, dedicates phased-array bilateral breast coil |
Turnbull (COMICE) 2010 [20] | UK | RCT (subgroup analysis) | MRI: 43 No MRI: 48 | Microcalcification: NR Mean size (mm): NR | NR | 1.5 T, dedicated breast-surface coils for signal reception, with a few scans done at 1.0 T |
Allen 2010 [22] | USA | Retrospective cohort | MRI: 64 No MRI: 35 | Microcalcification: NR Mean size (mm): NR | MRI: 60.5 (40–83) No MRI: 64.4 (41–89) | 1.5 T using 8 channel breast-surface coil |
Besharat 2018 [40] | Iran | One arm retrospective cohort | MRI: 5 | Microcalcification: NR Mean size (mm): NR | All patients (DCIS + invasive): 45.5 | 1.5 T |
Davis 2012 [23] | USA | Retrospective cohort, comparing two different time periods | MRI: 154 No MRI: 64 | Microcalcification: NR Mean size (mm): NR | NR | 1.5-T scanner with use of a dedicated prone eight-channel breast coil |
Duygulu 2012 [41] | Turkey | One arm retrospective cohort | MRI: 18 | Microcalcification: NR Mean size (mm): NR | NR | 1.5 T using a standard breast coil in the prone position |
Hajaj 2017 [24] | UK | Retrospective cohort from one hospital, comparing two different time periods | MRI: 70 No MRI: 52 | Microcalcification: NR Size range (mm): MRI: 2 to 110; no MRI: 3 to 180 | MRI: 63 (31–75) No MRI: (56–82) | 1.5-T scanner and a dedicated 8-channel breast coil |
Hlubocky 2018 [38] | USA | One arm retrospective cohort in two sites | MRI: 288 | Microcalcification: NR Mean size: NR | NR | Initially with 1.5-T magnets; later, all were performed on 3.0 T |
Itakura 2011 [11] | USA | Retrospective cohort | MRI: 38; No MRI: 111 | Microcalcification: NR Size median (mm): MRI: 16, no MRI: 10 | MRI: median: 50 (24–71) No MRI: median: 59 (38–86) | NR |
Keymeulen 2019 [33] | Netherlands | Retrospective cohort (population registries) | MRI: 2382 No MRI: 8033 | Microcalcification: NR Mean size: NR | MRI: 50–74 years (74%) No MRI: 50–74 years (88%) | NR |
Kropcho 2012 [25] | USA | Retrospective cohort from one site | MRI: 62; No MRI: 98 | Microcalcification: NR Mean size (mm): MRI: 20.9, no MRI: 27.8 | MRI: 55 (35–78) No MRI: 62 (38–93) | 1.5-T magnet using a dedicated four-channel in vivo breast coil |
Lam 2019 [34] | USA | Retrospective cohort fromone hospital | MRI: 332 No MRI: 41 | Microcalcification: NR Mean size: NR | All patients: 55.5 | NR |
Lamb 2020 [36] | USA | Restrospective cohort from one hospital | MRI: 236 No MRI: 727 | Microcalcification: all patients Mean size: NR | MRI: 50.6 ± 8.8 No MRI: 60.2 ± 10 | 1.5 T or 3 T |
Korea | One arm retrospective cohort in one site | MRI: 199 | NR | All patients: 50.1 ± 9.4 | 1.5-T system with a dedicated 4-channel breast coil | |
Obdeijn 2013 [26] | Netherlands | Retrospective cohort, comparing two different time periods (subgroup analysis) | MRI: 11 No MRI: 27 | Microcalcification: NR Mean size (mm): NR | NR | 1.5-T system with a dedicated double breast coil |
Onega 2017 [27] | USA | Retrospective cohort (Breast Cancer Surveillance Consortium (BCSC)) | MRI: 354 No MRI: 2083 | Microcalcification: NR Mean size (mm): NR | NR | NR |
Pettit 2009 [39] | USA | One-arm retrospective cohort (subgroup analysis) | MRI: 51 | Microcalcification: NR Mean size (mm): NR | NR | Siemens 1.5-T Sonata or Espree magnetic resonance imaging unit with dedicated breast coil |
Pilewskie 2013 [12] | USA | Prospective cohort from the Lynn Sage Comprehensive Breast Center | MRI: 217; No MRI: 135 | Microcalcification: MRI: 75.8 %, no MRI: 93.8 % Mean size cm (range): MRI: 2.1 (0.0, 10.0), no MRI: 1.7 (0.0, 9.0) | MRI: 53 (26–82) No MRI: 60 (36–86) | NR |
Pilewskie 2014 [28] | USA | Retrospective cohort from the Memorial Sloan-Kettering Cancer Center (MSKCC) | MRI: 596; No MRI: 1723 | Microcalcification: NR Mean size (mm): NR | MRI: 54.0 (26-73) No MRI: 53.5 (25–85) | NR |
Shin 2012 [29] | Korea | Retrospective cohort (subgroup analysis) | MRI: 62; No MRI: 25 | Microcalcification: NR Mean size (mm): NR | NR | A 1.5-T imager with dedicated double-breast coil was used |
So 2018 [30] | USA | Retrospective cohort from one site | MRI: 97; No MRI: 79 | Microcalcification: NR Mean size ± SD: MRI: 1.5 ± 1.9, no MRI: 1.6 ± 2.6 | MRI: 56.4 No MRI: 63.6 | NR |
Solin 2008 [42] | USA | Retrospective cohort from one site | MRI: 31 No MRI: 105 | Microcalcification: NR Mean size (mm): NR | NR | NR |
Vapiwala 2017 [31] | USA | Retrospective cohort (subgroup analysis) | MRI: 31; No MRI: 104 | Microcalcification: NR Mean size (mm): NR | Microcalcification: NR Mean size (mm): NR | NR |
Vos 2015 [32] | Netherlands | Retrospective cohort, population-based (subgroup analysis—high-grade DCIS) | MRI: 136 No MRI: 478 | Microcalcification: NR Mean size (mm): NR | NR | Dynamic contrast-enhanced MRI |
Yoon 2020 [35] | Korea | Retrospective cohort from one hospital | MRI: 106 No MRI: 106 (post propensity matching) | Microcalcification: NR Mean size (cm): 3.0 ± 2.4 | All patients: 53.5 ± 10 (post propensity matching) | A 1.5-T or 3-T with dedicated double-breast coil was used |