Skip to main content
SpringerLink
Log in

Solving the preoperative breast MRI conundrum: design and protocol of the MIPA study

European Radiology volume 30, pages 5427–5436 (2020)Cite this article

Abstract

Despite its high diagnostic performance, the use of breast MRI in the preoperative setting is controversial. It has the potential for personalized surgical management in breast cancer patients, but two of three randomized controlled trials did not show results in favor of its introduction for assessing the disease extent before surgery. Meta-analyses showed a higher mastectomy rate in women undergoing preoperative MRI compared to those who do not. Nevertheless, preoperative breast MRI is increasingly used and a survey from the American Society of Breast Surgeons showed that 41% of respondents ask for it in daily practice. In this context, a large-scale observational multicenter international prospective analysis (MIPA study) was proposed under the guidance of the European Network for the Assessment of Imaging in Medicine (EuroAIM). The aims were (1) to prospectively and systematically collect data on consecutive women with a newly diagnosed breast cancer, not candidates for neoadjuvant therapy, who are offered or not offered breast MRI before surgery according to local practice; (2) to compare these two groups in terms of surgical and clinical endpoints, adjusting for covariates. The underlying hypotheses are that MRI does not cause additional mastectomies compared to conventional imaging, while reducing the reoperation rate in all or in subgroups of patients. Ninety-six centers applied to a web-based call; 36 were initially selected based on volume and quality standards; 27 were active for enrollment. On November 2018, the target of 7000 enrolled patients was reached. The MIPA study is presently at the analytic phase.

Key Points

• Breast MRI has a high diagnostic performance but its utility in the preoperative setting is controversial.

• A large-scale observational multicenter prospective study was launched to compare women receiving with those not receiving preoperative MRI.

• Twenty-seven centers enrolled more than 7000 patients. The study is presently at the analytic phase.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1

Abbreviations

BCS:

Breast-conserving surgery

EuroAIM:

European Network for the Assessment of Imaging in Medicine

EUSOBI:

European Society of Breast Imaging

MRI:

Magnetic resonance imaging

OR:

Odds ratio

RCT:

Randomized controlled trial

References

  1. Veronesi U, Cascinelli N, Mariani L et al (2002) Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med 347:1227–1232. https://doi.org/10.1056/NEJMoa020989

    Article  PubMed  Google Scholar 

  2. Fisher B, Anderson S, Bryant J et al (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241. https://doi.org/10.1056/NEJMoa022152

    Article  PubMed  Google Scholar 

  3. Bucchi L, Belli P, Benelli E et al (2016) Recommendations for breast imaging follow-up of women with a previous history of breast cancer: position paper from the Italian Group for Mammography Screening (GISMa) and the Italian College of Breast Radiologists (ICBR) by SIRM. Radiol Med 121:891–896. https://doi.org/10.1007/s11547-016-0676-8

    Article  PubMed  PubMed Central  Google Scholar 

  4. Houssami N, Macaskill P, Marinovich ML et al (2010) Meta-analysis of the impact of surgical margins on local recurrence in women with early-stage invasive breast cancer treated with breast-conserving therapy. Eur J Cancer 46:3219–3232. https://doi.org/10.1016/j.ejca.2010.07.043

    Article  PubMed  Google Scholar 

  5. Kurniawan ED, Wong MH, Windle I et al (2008) Predictors of surgical margin status in breast-conserving surgery within a breast screening program. Ann Surg Oncol 15:2542–2549. https://doi.org/10.1245/s10434-008-0054-4

    Article  PubMed  Google Scholar 

  6. Kuhl C, Weigel S, Schrading S et al (2010) Prospective multicenter cohort study to refine management recommendations for women at elevated familial risk of breast cancer: the EVA trial. J Clin Oncol 28:1450–1457. https://doi.org/10.1200/JCO.2009.23.0839

    Article  PubMed  Google Scholar 

  7. Sardanelli F, Podo F, Santoro F et al (2011) Multicenter surveillance of women at high genetic breast cancer risk using mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (the high breast cancer risk Italian 1 study): final results. Invest Radiol 46:94–105. https://doi.org/10.1097/RLI.0b013e3181f3fcdf

    Article  PubMed  Google Scholar 

  8. Obdeijn IM, Winter-Warnars GA, Mann RM et al (2014) Should we screen BRCA1 mutation carriers only with MRI? A multicenter study. Breast Cancer Res Treat 144:577–582. https://doi.org/10.1007/s10549-014-2888-8

    Article  CAS  PubMed  Google Scholar 

  9. Chiarelli AM, Prummel MV, Muradali D et al (2014) Effectiveness of screening with annual magnetic resonance imaging and mammography: results of the initial screen from the Ontario high risk breast screening program. J Clin Oncol 32:2224–2230. https://doi.org/10.1200/JCO.2013.52.8331

    Article  PubMed  Google Scholar 

  10. Riedl CC, Luft N, Bernhart C et al (2015) Triple-modality screening trial for familial breast cancer underlines the importance of magnetic resonance imaging and questions the role of mammography and ultrasound regardless of patient mutation status, age, and breast density. J Clin Oncol 33:1128–1135. https://doi.org/10.1200/JCO.2014.56.8626

    Article  PubMed  PubMed Central  Google Scholar 

  11. Phi XA, Saadatmand S, De Bock GH et al (2016) Contribution of mammography to MRI screening in BRCA mutation carriers by BRCA status and age: individual patient data meta-analysis. Br J Cancer 114:631–637. https://doi.org/10.1038/bjc.2016.32

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Lo G, Scaranelo AM, Aboras H et al (2017) Evaluation of the utility of screening mammography for high-risk women undergoing screening breast MR imaging. Radiology 285:36–43. https://doi.org/10.1148/radiol.2017161103

    Article  PubMed  Google Scholar 

  13. Sardanelli F, Giuseppetti GM, Panizza P et al (2004) Sensitivity of MRI versus mammography for detecting foci of multifocal, multicentric breast cancer in fatty and dense breasts using the whole-breast pathologic examination as a gold standard. AJR Am J Roentgenol 183:1149–1157. https://doi.org/10.2214/ajr.183.4.1831149

    Article  PubMed  Google Scholar 

  14. Sardanelli F, Newstead GM, Putz B et al (2016) Gadobutrol-enhanced magnetic resonance imaging of the breast in the preoperative setting: results of 2 prospective international multicenter phase III studies. Invest Radiol 51:454–461. https://doi.org/10.1097/RLI.0000000000000254

    Article  CAS  PubMed  Google Scholar 

  15. Iacconi C, Galman L, Zheng J et al (2016) Multicentric cancer detected at breast MR imaging and not at mammography: important or not? Radiology 279:378–384. https://doi.org/10.1148/radiol.2015150796

    Article  PubMed  Google Scholar 

  16. Plana MN, Carreira C, Muriel A et al (2012) Magnetic resonance imaging in the preoperative assessment of patients with primary breast cancer: systematic review of diagnostic accuracy and meta-analysis. Eur Radiol 22:26–38. https://doi.org/10.1007/s00330-011-2238-8

    Article  PubMed  Google Scholar 

  17. Holland R, Veling SH, Mravunac M, Hendriks JH (1985) Histologic multifocality of Tis, T1-2 breast carcinomas. Implications for clinical trials of breast-conserving surgery. Cancer 56:979–990. https://doi.org/10.1002/1097-0142(19850901)56:5<979::aid-cncr2820560502>3.0.co;2-n

  18. Brennan ME, Houssami N, Lord S et al (2009) Magnetic resonance imaging screening of the contralateral breast in women with newly diagnosed breast cancer: systematic review and meta-analysis of incremental cancer detection and impact on surgical management. J Clin Oncol 27:5640–5649. https://doi.org/10.1200/JCO.2008.21.5756

    Article  PubMed  Google Scholar 

  19. Turnbull L, Brown S, Harvey I et al (2010) Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomized controlled trial. Lancet 375:563–571. https://doi.org/10.1016/S0140-6736(09)62070-5

    Article  PubMed  Google Scholar 

  20. Peters NH, van Esser S, van den Bosch MA et al (2011) Preoperative MRI and surgical management in patients with nonpalpable breast cancer: the MONET - randomised controlled trial. Eur J Cancer 47:879–886. https://doi.org/10.1016/j.ejca.2010.11.035

    Article  CAS  PubMed  Google Scholar 

  21. Gonzalez V, Sandelin K, Karlsson A et al (2014) Preoperative MRI of the breast (POMB) influences primary treatment in breast cancer: a prospective, randomized, multicenter study. World J Surg 38:1685–1693. https://doi.org/10.1007/s00268-014-2605-0

    Article  PubMed  Google Scholar 

  22. Balleyguier C, Dunant A, Ceugnart L et al (2019) Preoperative breast magnetic resonance imaging in women with local ductal carcinoma in situ to optimize surgical outcomes: results from the randomized phase III trial IRCIS. J Clin Oncol 37:885–892. https://doi.org/10.1200/JCO.18.00595

    Article  PubMed  Google Scholar 

  23. Houssami N, Turner R, Morrow M (2013) Preoperative magnetic resonance imaging in breast cancer: meta-analysis of surgical outcomes. Ann Surg 257:249–255. https://doi.org/10.1097/SLA.0b013e31827a8d17

    Article  PubMed  Google Scholar 

  24. Houssami N, Turner R, Macaskill P et al (2014) An individual person data meta-analysis of preoperative magnetic resonance imaging and breast cancer recurrence. J Clin Oncol 32:392–401. https://doi.org/10.1200/JCO.2013.52.7515

    Article  PubMed  Google Scholar 

  25. Houssami N, Turner RM, Morrow M (2017) Meta-analysis of pre-operative magnetic resonance imaging (MRI) and surgical treatment for breast cancer. Breast Cancer Res Treat 165:273–283. https://doi.org/10.1007/s10549-017-4324-3

    Article  PubMed  PubMed Central  Google Scholar 

  26. Sardanelli F (2010) Additional findings at preoperative MRI: a simple golden rule for a complex problem? Breast Cancer Res Treat 124:717–721. https://doi.org/10.1007/s10549-010-1144-0

    Article  PubMed  Google Scholar 

  27. Sardanelli F, Trimboli RM (2012) Preoperative MRI: did randomized trials conclude the debate? Eur J Radiol 81(Suppl 1):S135–S136. https://doi.org/10.1016/S0720-048X(12)70056-6

    Article  PubMed  Google Scholar 

  28. Solin LJ (2010) Counterview: pre-operative breast MRI (magnetic resonance imaging) is not recommended for all patients with newly diagnosed breast cancer. Breast 19:7–9. https://doi.org/10.1016/j.breast.2009.11.004

    Article  PubMed  Google Scholar 

  29. Houssami N, Solin LJ (2010) An appraisal of pre-operative MRI in breast cancer: more effective staging of the breast or much ado about nothing? Maturitas 67:291–293. https://doi.org/10.1016/j.maturitas.2010.08.008

    Article  CAS  PubMed  Google Scholar 

  30. Jatoi I, Benson JR (2013) The case against routine preoperative breast MRI. Future Oncol 9:347–353. https://doi.org/10.2217/fon.12.186

    Article  CAS  PubMed  Google Scholar 

  31. Gupta D, Billadello L (2017) Breast MR imaging in newly diagnosed breast cancer. Radiol Clin North Am 55:541–552. https://doi.org/10.1016/j.rcl.2016.12.008

    Article  PubMed  Google Scholar 

  32. Ray KM, Hayward JH, Joe BN (2018) Role of MR imaging for the locoregional staging of breast cancer. Magn Reson Imaging Clin N Am 26:191–205. https://doi.org/10.1016/j.mric.2017.12.008

  33. American Society of Breast Surgeons web-site. http://www.choosingwisely.org/societies/american-society-of-breast-surgeons/. Accessed 28 Aug 2019

  34. Parker A, Schroen AT, Brenin DR (2013) MRI utilization in newly diagnosed breast cancer: a survey of practicing surgeons. Ann Surg Oncol 20:2600–2606. https://doi.org/10.1245/s10434-013-2934-5

    Article  PubMed  Google Scholar 

  35. Lee J, Tanaka E, Eby PR et al (2017) Preoperative breast MRI: surgeons’ patient selection patterns and potential bias in outcomes analyses. AJR Am J Roentgenol 208:923–932. https://doi.org/10.2214/AJR.16.17038

    Article  PubMed  Google Scholar 

  36. Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316. https://doi.org/10.1016/j.ejca.2010.02.015

    Article  PubMed  Google Scholar 

  37. Mann RM, Balleyguier C, Baltzer PA et al (2015) Breast MRI: EUSOBI recommendations for women’s information. Eur Radiol 25:3669–3678. https://doi.org/10.1007/s00330-015-3807-z

  38. American College of Radiology (2018) Practice parameter for the performance of contrast-enhanced magnetic resonance imaging (MRI) of the breast. https://www.acr.org/-/media/ACR/Files/Practice-Parameters/mr-contrast-breast.pdf. Accessed 28 Aug 2019

  39. Allegra CJ, Aberle DR, Ganschow P et al (2009) NIH state-of-the-science conference statement: diagnosis and management of ductal carcinoma in situ (DCIS). NIH Consens State Sci Statements 26:1–27 https://consensus.nih.gov/2009/dcisstatement.htm

    PubMed  Google Scholar 

  40. Bleyer A, Welch HG (2012) Effect of three decades of screening mammography on breast-cancer incidence. N Engl J Med 367:1998–2005. https://doi.org/10.1056/NEJMoa1206809

  41. Harms SE, Flamig DP, Hesley KL et al (1993) MR imaging of the breast with rotating delivery of excitation off resonance: clinical experience with pathologic correlation. Radiology 187:493–501. https://doi.org/10.1148/radiology.187.2.8475297

    Article  CAS  PubMed  Google Scholar 

  42. Kaiser WA (1994) False-positive results in dynamic MR mammography. Causes, frequency, and methods to avoid. Magn Reson Imaging Clin N Am 2:539–555

    CAS  PubMed  Google Scholar 

  43. Carbonaro LA, Tannaphai P, Trimboli RM, Verardi N, Fedeli MP, Sardanelli F (2012) Contrast-enhanced breast MRI: spatial displacement from prone to supine patient's position. Preliminary results. Eur J Radiol 81:e771–e774. https://doi.org/10.1016/j.ejrad.2012.02.013

  44. Spick C, Baltzer PA (2014) Diagnostic utility of second-look US for breast lesions identified at MR imaging: systematic review and meta-analysis. Radiology 273:401–409. https://doi.org/10.1148/radiol.14140474

    Article  PubMed  Google Scholar 

  45. Clauser P, Carbonaro LA, Pancot M et al (2015) Additional findings at preoperative breast MRI: the value of second-look digital breast tomosynthesis. Eur Radiol 25:2830–2839. https://doi.org/10.1007/s00330-015-3720-5

    Article  PubMed  Google Scholar 

  46. Spick C, Schernthaner M, Pinker K et al (2016) MR-guided vacuum-assisted breast biopsy of MRI-only lesions: a single center experience. Eur Radiol 26:3908–3916. https://doi.org/10.1007/s00330-016-4267-9

    Article  PubMed  PubMed Central  Google Scholar 

  47. Oxford Centre for Evidence-based Medicine. Levels of Evidence. https://www.cebm.net/2009/06/oxford-centre-evidence-based-medicine-levels-evidence-march-2009/. Accessed 16 Aug 2019

  48. The Council of the European Union (2003) Council recommendation of 2 December 2003 on cancer screening (2003/878/EC). https://ec.europa.eu/jrc/sites/jrcsh/files/2_December_2003cancerscreening.pdf. Accessed 16 Aug 2019

  49. Nabhan C, Klink A, Prasad V (2019) Real-world evidence-what does it really mean? JAMA Oncol 5:781–783. https://doi.org/10.1001/jamaoncol.2019.0450

    Article  PubMed  Google Scholar 

  50. Corrigan-Curay J, Sacks L, Woodcock J (2018) Real-world evidence and real-world data for evaluating drug safety and effectiveness. JAMA 320:867–868. https://doi.org/10.1001/jama.2018.10136

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The study was promoted by the European Network for the Assessment of Imaging in Medicine (EuroAIM), initiative of the European Institute for Biomedical Imaging Research (EIBIR) and endorsed by the European Society of Breast Imaging. The authors thank Bayer Healthcare that provided an unconditional research grant, in particular Dr. Stephanie Schermuck-Joschko (who passed away for a car accident after the study started) and Dr. Jan Endrikat. The authors also thank Monika Hierath, Eva Haas, Katharina Krischak, and Peter Gordebeke from the EIBIR staff which managed all the administrative work of this study.

The following persons collaborated at individual centers: Lucia Camera, MD, Department of Radiology, Azienda Ospedaliera Universitaria Integrata, Verona, Italy; Sara Mirandola, MD, Department of Surgery, Azienda Ospedaliera Universitaria Integrata, Verona, Italy; Marta Maria Panzeri, MD, Department of Breast Radiology, IRCCS Ospedale San Raffaele, Milan, Italy; Maria A. Rodi Carvalho Barros Bernardes, MD and Vera L. Nunes Aguillar, MD, PhD, Department of Radiology, Hospital Sirio Libanes, Sao Paulo, Brazil; Katja Siegmann-Luz, MD and Benjamin Wiesinger, MD, Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen, Germany; James M. Anderson, Max Hobbs, and Wanda Gunawan, Royal Perth Hospital, Perth, Australia.

Funding

This study has received funding by Bayer Healthcare.

Author information

Authors and Affiliations

  1. Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Morandi 30, 20097, San Donato Milanese, Italy

    Francesco Sardanelli & Rubina M. Trimboli

  2. Unit of Radiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, Italy

    Francesco Sardanelli & Giovanni Di Leo

  3. Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia

    Nehmat Houssami

  4. Department of Radiology, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK

    Fiona J. Gilbert & Sarah Hilborne

  5. Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna, Vienna, Austria

    Thomas H. Helbich & Paola Clauser

  6. Department of Radiology, Hospital Universitario Reina Sofía, Córdoba, Spain

    Marina Alvarez Benito

  7. Department of Radiology, Gustave-Roussy Institute, Villejuif, France

    Corinne Balleyguier

  8. Institute of Radiology, Department of Medicine, University of Udine, University Hospital S. Maria della Misericordia, Udine, Italy

    Massimo Bazzocchi, Rossano Girometti & Chiara Zuiani

  9. Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands

    Peter Bult

  10. Unit of Breast Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy

    Massimo Calabrese

  11. Department of Radiology, University Hospital of La Ribera, Alzira, Spain

    Julia Camps Herrero

  12. Jefa Corporativa del Área de la Mama, Ribera Salud Grupo, Valencia, Spain

    Julia Camps Herrero

  13. Unit of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Francesco Cartia, Catherine Depretto & Gianfranco P. Scaperrotta

  14. Breast Imaging Division, European Institute of Oncology, Milan, Italy

    Enrico Cassano

  15. Department of Breast Surgery, Hospital Sírio Libanês, Sao Paulo, Brazil

    Danubia A. de Andrade

  16. Department of Radiology, Hospital Sírio Libanês, Sao Paulo, Brazil

    Marcos F. de Lima Docema

  17. Department of Radiology, MHEK Teaching Hospital University Semmelweis, Budapest, Hungary

    Gabor Forrai

  18. Department of Radiology, Duna Medical Center, Budapest, Hungary

    Gabor Forrai

  19. Breast Center of Northwest Arkansas, Fayetteville, AR, USA

    Steven E. Harms

  20. Department of Radiology Di.Bi.MED, University of Palermo, Policlinico P. Giaccone, Palermo, Italy

    Raffaele Ienzi

  21. Department of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands

    Marc B. I. Lobbes

  22. Department of Radiology, Zuyderland Medical Center, Sittard-Geleen, The Netherlands

    Marc B. I. Lobbes

  23. Department of Breast Radiology, IRCCS Ospedale San Raffaele, Milan, Italy

    Claudio Losio

  24. Department of Radiology and Nuclear Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

    Ritse M. Mann

  25. Department of Radiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Ritse M. Mann

  26. Department of Radiology, University Hospital of Verona, Verona, Italy

    Stefania Montemezzi

  27. Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands

    Inge-Marie Obdeijn

  28. Unit of Radiology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey

    Umit Aksoy Ozcan & Ozden S. Ulus

  29. Department of Radiological, Oncological and Pathological Sciences, Sapienza University of Rome, Rome, Italy

    Federica Pediconi

  30. Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany

    Heike Preibsch

  31. Deparment of Radiology, Hospital Universitario Reina Sofía, Córdoba, Spain

    José L. Raya-Povedano

  32. Kiwifarm Srl, La Morra, Italy

    Daniela Sacchetto

  33. Disaster Medicine Service 118, ASL CN1, Saluzzo, Italy

    Daniela Sacchetto

  34. CRIMEDIM, Research Center in Emergency and Disaster Medicine, Università del Piemonte Orientale, Novara, Italy

    Daniela Sacchetto

  35. Department of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands

    Margrethe Schlooz

  36. Department of Radiology, Barking Havering and Redbridge University Hospitals NHS Trust, London, UK

    Botond K. Szabo

  37. Medical School, Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia

    Donna B. Taylor

  38. Department of Radiology, Royal Perth Hospital, Perth, Australia

    Donna B. Taylor

  39. Gynecological Oncology Unit, Department of Obstetrics and Gynecology, Department of Radiology, Multidisciplinary Breast Clinic, Antwerp University Hospital-University of Antwerp, Antwerp, Belgium

    Mireille Van Goethem

  40. Maatschap Radiologie Oost-Nederland, Oldenzaal, The Netherlands

    Jeroen Veltman

  41. Institute of Clinical Radiology and Reference Center for Mammography, University of Münster, Münster, Germany

    Stefanie Weigel

  42. Department of Radiology, University Hospital of Erlangen, Erlangen, Germany

    Evelyn Wenkel

Authors
  1. Francesco Sardanelli
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rubina M. Trimboli
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nehmat Houssami
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fiona J. Gilbert
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Thomas H. Helbich
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marina Alvarez Benito
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Corinne Balleyguier
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Massimo Bazzocchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Peter Bult
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Massimo Calabrese
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Julia Camps Herrero
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Francesco Cartia
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Enrico Cassano
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Paola Clauser
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Danubia A. de Andrade
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Marcos F. de Lima Docema
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Catherine Depretto
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Gabor Forrai
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Rossano Girometti
    View author publications

    You can also search for this author in PubMed Google Scholar

  20. Steven E. Harms
    View author publications

    You can also search for this author in PubMed Google Scholar

  21. Sarah Hilborne
    View author publications

    You can also search for this author in PubMed Google Scholar

  22. Raffaele Ienzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  23. Marc B. I. Lobbes
    View author publications

    You can also search for this author in PubMed Google Scholar

  24. Claudio Losio
    View author publications

    You can also search for this author in PubMed Google Scholar

  25. Ritse M. Mann
    View author publications

    You can also search for this author in PubMed Google Scholar

  26. Stefania Montemezzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  27. Inge-Marie Obdeijn
    View author publications

    You can also search for this author in PubMed Google Scholar

  28. Umit Aksoy Ozcan
    View author publications

    You can also search for this author in PubMed Google Scholar

  29. Federica Pediconi
    View author publications

    You can also search for this author in PubMed Google Scholar

  30. Heike Preibsch
    View author publications

    You can also search for this author in PubMed Google Scholar

  31. José L. Raya-Povedano
    View author publications

    You can also search for this author in PubMed Google Scholar

  32. Daniela Sacchetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  33. Gianfranco P. Scaperrotta
    View author publications

    You can also search for this author in PubMed Google Scholar

  34. Margrethe Schlooz
    View author publications

    You can also search for this author in PubMed Google Scholar

  35. Botond K. Szabo
    View author publications

    You can also search for this author in PubMed Google Scholar

  36. Ozden S. Ulus
    View author publications

    You can also search for this author in PubMed Google Scholar

  37. Donna B. Taylor
    View author publications

    You can also search for this author in PubMed Google Scholar

  38. Mireille Van Goethem
    View author publications

    You can also search for this author in PubMed Google Scholar

  39. Jeroen Veltman
    View author publications

    You can also search for this author in PubMed Google Scholar

  40. Stefanie Weigel
    View author publications

    You can also search for this author in PubMed Google Scholar

  41. Evelyn Wenkel
    View author publications

    You can also search for this author in PubMed Google Scholar

  42. Chiara Zuiani
    View author publications

    You can also search for this author in PubMed Google Scholar

  43. Giovanni Di Leo
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Francesco Sardanelli.

Ethics declarations

Guarantor

The scientific guarantor of this publication is Professor Francesco Sardanelli (Università degli Studi di Milano).

Conflict of interest

The authors of this manuscript declare the following relationships with companies:

Thomas Helbich receives research funding from Siemens, Guerbet, Bracco, Hologic and Nocomed.

Francesco Sardanelli received research grants from and is a member of the speakers’ bureau of GE Healthcare, Bayer, and Bracco; he is also a member of the Bracco Advisory Group.

Fiona J Gilbert received research grants from GE Healthcare, GSK, and Hologic and had research collaborations with Volpara and Bayer. She is an NIHR senior investigator and receives funding from the Cambridge BRC.

Marc Lobbes received research grant and is a member of the speakers’ bureau of GE Healthcare.

Nehmat Houssami receives research funding via a National Breast Cancer Foundation (NBCF Australia) Breast Cancer Research Leadership Fellowship.

Statistics and biometry

One of the authors has significant statistical expertise.

Informed consent

Written informed consent was obtained from all subjects (patients) in this study.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• prospective

• observational

• multicenter study

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

ESM 1

(DOCX 20 kb)

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sardanelli, F., Trimboli, R.M., Houssami, N. et al. Solving the preoperative breast MRI conundrum: design and protocol of the MIPA study. Eur Radiol 30, 5427–5436 (2020). https://doi.org/10.1007/s00330-020-06824-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-020-06824-7

Keywords

search

Navigation