Preoperative breast MRI for early-stage breast cancer: effect on surgical and long-term outcomes
| Autor: | Jie Li, Kimberly J. Van Zee, Glenys Da Costa, Janice S. Sung, Sujata Patil, D. David Dershaw, Elizabeth A. Morris |
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| Rok vydání: | 2014 |
| Předmět: |
Oncology
medicine.medical_specialty Lymphovascular invasion Breast Neoplasms Disease-Free Survival law.invention Breast cancer Randomized controlled trial law Risk Factors Internal medicine Preoperative Care medicine Adjuvant therapy Breast MRI Humans Radiology Nuclear Medicine and imaging Longitudinal Studies Stage (cooking) skin and connective tissue diseases Survival rate Lymph node Mastectomy Neoplasm Staging medicine.diagnostic_test business.industry Incidence General Medicine Middle Aged medicine.disease Prognosis Magnetic Resonance Imaging United States Survival Rate medicine.anatomical_structure Treatment Outcome Female Radiology Neoplasm Recurrence Local business |
| Zdroj: | AJR. American journal of roentgenology. 202(6) |
| ISSN: | 1546-3141 |
| Popis: | The purpose of this study was to evaluate the effect of the use of preoperative breast MRI on surgical and long-term outcomes among women with early-stage breast cancer undergoing breast conservation therapy.A retrospective review yielded the cases of 174 women with stage 0, I, or II breast cancer who underwent preoperative MRI between 2000 and 2004. A control group of 174 patients who did not undergo preoperative MRI before breast conservation therapy was matched by age, histopathologic finding, stage, and surgeon. Features compared included breast density, presence of mammographically occult disease, margin status, lymph node involvement, lymphovascular invasion, extensive intraductal component, hormone receptor status, and use of adjuvant therapy. Outcomes, including rates of reexcision, ipsilateral recurrence, and disease-free survival, were compared by Kaplan-Meier methods and the log-rank test.Patients referred for preoperative breast MRI were more likely to have extremely dense breasts (28% vs 6%, p0.0001) and mammographically occult cancer (24% vs 9%, p = 0.0003). The two groups had identical rates of final negative margins, lymph node involvement, lymphovascular invasion, extensive intraductal component status, positive hormone receptor results, and systemic adjuvant therapy. Fewer patients in the preoperative MRI group needed reexcision (29% vs 45%, p = 0.02). The median follow-up period after treatment was 8 years. There was no significant difference in locoregional recurrence (p = 0.33) or disease-free survival (p = 0.73) rates between the two groups.Reexcision rates among patients with early breast cancer undergoing conservation therapy were lower among women who underwent preoperative breast MRI. There was no statistically significant effect of the use of preoperative MRI on rates of locoregional recurrence or disease-free survival. |
| Databáze: | OpenAIRE |
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