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Relationship of breast MRI to recurrence rates in patients undergoing breast-conservation treatment

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Abstract

Purpose

The effect of pre-operative MRI on the in-breast tumor recurrence rate (IBTR) of patients undergoing breast-conservation treatment (BCT) remains uncertain. We began to routinely perform pre-operative MRI in 2006. Our goal was to determine the effect of pre-operative MRI on IBTR.

Methods

Retrospective review of a prospective database of all patients undergoing BCT (n = 1396) from 2000 to 2010. IBTR were calculated using Kaplan–Meier estimates.

Results

664 (47.6%) patients underwent pre-operative MRI. The use of MRI increased from 13.9% in 2000–2005 to 80.7% in 2006–2010. Ten percent of patients who underwent MRI were found to have an additional ipsilateral cancer, with a mean diameter of 1.6 cm. The IBTR for patients with and without MRI were 4% vs. 8% at 8 years (p = 0.04). In multivariate analysis, radiation therapy and endocrine therapy were associated with decreased IBTR, but MRI was not (RR 0.77 (0.45–1.28)). For 1030 patients with invasive cancer, the IBTR at 8 years with and without MRI was 4.2% vs. 7.3% (p = 0.28). For 366 DCIS patients with and without MRI, the IBTR was 3.6% vs. 10.9% (p = 0.06). In the subgroup of DCIS patients who did not receive radiation, the IBTR with and without MRI was 0% vs. 18.2% (p = 0.08). Patients with an additional cancer found by MRI had a higher IBTR at 8 years (10.1% vs. 3.3%, p = 0.02).

Conclusions

In a study analyzing BCT patients from one time period who rarely had a pre-operative MRI and a subsequent time period where most patients had MRI, the use of MRI was associated with a decrease in the IBTR on univariate, but not multivariate analysis. Patients who had additional cancers detected had a significantly higher IBTR.

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Authors and Affiliations

  1. Section of General Surgery, Dartmouth Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH, 03756, USA

    Maureen V. Hill, Julia L. Beeman, Stefan D. Holubar, Kari M. Rosenkranz & Richard J. Barth Jr.

  2. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Khushboo Jhala

Authors
  1. Maureen V. Hill
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  2. Julia L. Beeman
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  3. Khushboo Jhala
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  4. Stefan D. Holubar
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  5. Kari M. Rosenkranz
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  6. Richard J. Barth Jr.
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Corresponding author

Correspondence to Richard J. Barth Jr..

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Conflicts of interest

Richard J. Barth Jr. declares the following possible conflicts of interest: Stock ownership in Cairn Surgical, LLC; R21 NIH Grant, CA182956-01.

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Hill, M.V., Beeman, J.L., Jhala, K. et al. Relationship of breast MRI to recurrence rates in patients undergoing breast-conservation treatment. Breast Cancer Res Treat 163, 615–622 (2017). https://doi.org/10.1007/s10549-017-4205-9

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  • DOI: https://doi.org/10.1007/s10549-017-4205-9

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