Are we choosing wisely? Drivers of preoperative MRI use in breast cancer patients
| Autor: | Eric Brown, Amanda Mendiola, Melissa Lazar, Naveenraj L. Solomon, David W. Ollila, Marissa Howard-McNatt, Edward A. Levine, Anees B. Chagpar, Sonali V Pandya, Elisabeth Dupont, Carlos Garcia-Cantu, Mary Murray, Kristalyn K. Gallagher, Andrew Fenton, Jennifer Gass, Sharon S. Lum, Akiko Chiba, Laura Walters, Jukes P. Namm |
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| Rok vydání: | 2022 |
| Předmět: |
Male
medicine.medical_specialty Multivariate analysis medicine.medical_treatment Breast Neoplasms Mastectomy Segmental law.invention Breast cancer Randomized controlled trial Patient age law Preoperative Care medicine Breast-conserving surgery Humans Breast Stage (cooking) Neoadjuvant therapy Tumor histology business.industry General Medicine medicine.disease Magnetic Resonance Imaging Neoadjuvant Therapy Female Surgery Radiology business |
| Zdroj: | The American Journal of Surgery. 224:8-11 |
| ISSN: | 0002-9610 |
| Popis: | Factors contributing to the use of preoperative MRI remain poorly understood.Data from a randomized controlled trial of stage 0-3 breast cancer patients undergoing breast conserving surgery between 2016 and 2018 were analyzed.Of the 396 patients in this trial, 32.6% had a preoperative MRI. Patient age, race, ethnicity, tumor histology, and use of neoadjuvant therapy were significant predictors of MRI use. On multivariate analysis, younger patients with invasive lobular tumors were more likely to have a preoperative MRI. Rates also varied significantly by individual surgeon (p 0.001); in particular, female surgeons (39.9% vs. 24.0% for male surgeons, p = 0.001) and those in community practice (58.9% vs. 14.2% for academic, p 0.001) were more likely to order preoperative MRI. Rates declined over the two years of the study, particularly among female surgeons.Preoperative MRI varies with patient age and tumor histology; however, there remains variability by individual surgeon. |
| Databáze: | OpenAIRE |
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