Breast MRI for Extent of Disease: Association of Demographic Factors and Biopsy Compliance on Surgical Decisions in Patients with BI-RADS 4 and 5 Findings.

Autor:	Klein ED; Icahn School of Medicine at Mount Sinai, New York, NY, USA., Sonnenblick EB; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Sasson AL; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Anderson D; Dubin Breast Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Margolies LR; Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2023 Dec; Vol. 89 (12), pp. 6013-6019. Date of Electronic Publication: 2023 Jun 13.
DOI:	10.1177/00031348231183116
Abstrakt:	Background: The decision to pursue bilateral mastectomy without pathological confirmation of additional preoperative MRI lesions is likely multifactorial. We investigated the association of demographic factors and biopsy compliance following preoperative breast MRI with changes in surgical management in patients with newly diagnosed breast cancer. Methods: A retrospective review of BI-RADS 4 and 5 MRIs performed across a health system from March 2018 to November 2021 for assessment of disease extent and preoperative planning. Patient characteristics, including demographics, Tyrer-Cuzick risk score, pathology from index cancer and biopsy of MRI findings, and pre- and post-MRI surgical plans were recorded. Analysis compared patients who underwent biopsy with those who did not. Results: The final cohort included 323 patients who underwent a biopsy and 89 who did not. Of patients who underwent a biopsy, 144/323 (44.6%) had additional cancer diagnoses. MRI did not change management in 179/323 patients (55.4%) who underwent biopsy and in 44/89 patients (51.7%) who did not. Patients with a biopsy were more likely to have additional breast conservation surgery ( P < .001) and patients without a biopsy were more likely to have a change in management to bilateral mastectomy P = .009). Patients without a biopsy who underwent a management change to bilateral mastectomy were significantly younger (47.2 vs 58.6; P < .001) and more likely to be white ( P = .02) compared to those choosing bilateral mastectomy after biopsy. Discussion: Biopsy compliance is associated with changes in surgical decisions, and younger, white women are more likely to pursue aggressive surgical management without definitive pathologic diagnoses. Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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