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Who may benefit from preoperative breast MRI? A single-center analysis of 1102 consecutive patients with primary breast cancer

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Abstract

Several authors question the potential benefit of preoperative magnetic resonance imaging (MRI) against the background of possible overdiagnosis, false-positive findings, and unnecessary resections in patients with newly diagnosed breast cancer. In order to reveal a better selection of patients who should undergo preoperative MRI after histological confirmed breast cancer, the present analysis was implemented. We aimed to evaluate the influence of preoperative breast MRI in patients with newly diagnosed breast cancer to find subgroups of patients that are most likely to benefit from preoperative MRI by the detection of occult malignant foci. A total of 1102 consecutive patients who underwent treatment for primary breast cancer between 2002 and 2013 were retrospectively analyzed. All patients underwent triple assessment by breast ultrasound, mammography, and bilateral breast MRI. MRI findings not seen on conventional imaging that suggested additional malignant disease was found in 344 cases (31.2 %). Histological confirmed malignant foci were found in 223 patients (20.2 %) within the index breast and in 28 patients (2.5 %) in the contralateral breast. The rate of false-negative biopsies was 31 (2.8 %) and 62 (5.6 %), respectively. Premenopausal women (p = 0.024), lobular invasive breast cancer (p = 0.02) as well as patients with high breast density [American College of Radiology (ACR) 3 + 4; p = 0.01] were significantly associated with additional malignant foci in the index breast. Multivariate analysis confirmed lobular histology (p = 0.041) as well as the co-factors “premenopausal stage” and “high breast density (ACR 3+4)” (p = 0.044) to be independently significant. Previous studies revealed that breast MRI is a reliable tool for predicting tumor extension as well as for the detection of additional ipsilateral and contralateral tumor foci in histological confirmed breast cancer. In the present study, we demonstrate that especially premenopausal patients with high breast density as well as patients with lobular histology seem to profit from preoperative MRI.

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    Authors and Affiliations

    1. Department of Obstetrics and Gynecology, Centre for Integrated Oncology (CIO), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany

      Manuel Debald, Alina Abramian, Lisa Nemes, Michael Döbler, Christina Kaiser, Mignon-Denise Keyver-Paik, Michael Braun & Walther Kuhn

    2. Department of Radiology, Centre for Integrated Oncology, University of Bonn, Bonn, Germany

      Claudia Leutner & Hans H. Schild

    3. Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), University of Bonn, Bonn, Germany

      Tobias Höller

    4. Department of Gynecology, Red Cross Women’s Clinic Munich, Munich, Germany

      Michael Braun

    5. Department of Diagnostic and Interventional Radiology, University of Aachen RWTH, Aachen, Germany

      Christiane Kuhl

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    1. Manuel Debald
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    2. Alina Abramian
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    Correspondence to Manuel Debald.

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    Manuel Debald and Alina Abramian contributed equally to this work.

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    Debald, M., Abramian, A., Nemes, L. et al. Who may benefit from preoperative breast MRI? A single-center analysis of 1102 consecutive patients with primary breast cancer. Breast Cancer Res Treat 153, 531–537 (2015). https://doi.org/10.1007/s10549-015-3556-3

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    • DOI: https://doi.org/10.1007/s10549-015-3556-3

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