Abstract
Background
We evaluated whether a supplementary preoperative breast MRI in patients with invasive lobular breast cancer (ILC) has changed number and methods of primary and number of secondary surgical interventions.
Materials and Methods
This was a retrospective controlled single-center analysis of 178 ILC patients. The 2 study groups consisted of 92 patients with breast MRI (MRI group) and of 86 patients without breast MRI (non-MRI group). We investigated the primary and final surgical procedures and factors that influenced the number of secondary surgical interventions.
Results
A total of 40 primary mastectomies (38%) have been performed in the MRI group, compared with 27 (30%) in the non-MRI group (P = .119).There have been more bilateral surgical interventions in the MRI group (14 vs 3 patients; P = .002). The 2 groups did not differ with respect to secondary surgery rates (P = .429). The MRI and non-MRI group were significantly different with respect to age and breast density (P = .003 and P = .002). Yet, both variables seemed not to influence secondary surgery rates (P = .516 and P = .788, respectively).
Conclusions
The implementation of preoperative breast MRI tended to result in more primary mastectomies and bilateral surgeries and did not seem to decrease the secondary surgery rate.
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References
Arpino G, Bardou VJ, Clark GM, Elledge RM. Infiltrating lobular carcinoma of the breast: tumor characteristics and clinical outcome. Breast Cancer Res. 2004;6:R149–56.
Li CI, Anderson BO, Daling JR, Moe RE. Trends in incidence rates of invasive lobular and ductal breast carcinoma. JAMA. 2003;289:1421–4.
Turnbull L, Brown S, Harvey I, Olivier C, Drew P, Napp V, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial. Lancet. 375:563–71.
Kneeshaw PJ, Turnbull LW, Smith A, Drew PJ. Dynamic contrast enhanced magnetic resonance imaging aids the surgical management of invasive lobular breast cancer. Eur J Surg Oncol. 2003;29:32–7.
Quan ML, Sclafani L, Heerdt AS, Fey JV, Morris EA, Borgen PI. Magnetic resonance imaging detects unsuspected disease in patients with invasive lobular cancer. Ann Surg Oncol. 2003;10:1048–53.
Bedrosian I, Mick R, Orel SG, Schnall M, Reynolds C, Spitz FR, et al. Changes in the surgical management of patients with breast carcinoma based on preoperative magnetic resonance imaging. Cancer. 2003;98:468–73.
ACR Guidelines and Standards Committee. ACR practice guideline for the performance of contrast-enhanced magnetic resonance imaging (MRI) of the breast. 2008. Available from: http://www.acr.org/SecondaryMainMenuCategories/quality_safety/guidelines/breast/mri_breast.aspx.
Mann RM, Kuhl CK, Kinkel K, Boetes C. Breast MRI: guidelines from the European Society of Breast Imaging. Eur Radiol. 2008;18:1307–18.
Kreienberg R. Interdisciplinary S3 Guidelines for Diagnosis, Treatment and Follow-up Care of Breast Cancer. Interdisciplinary S3 Guidelines 2008; 1st updated Edition:[298]. Available from: http://www.senologie.org/download/pdf/s3_leitlinie_en.pdf.
Solin LJ, Orel SG, Hwang WT, Harris EE, Schnall MD. Relationship of breast magnetic resonance imaging to outcome after breast-conservation treatment with radiation for women with early-stage invasive breast carcinoma or ductal carcinoma in situ. J Clin Oncol. 2008;26:386–91.
Mann RM, Hoogeveen YL, Blickman JG, Boetes C. MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature. Breast Cancer Res Treat. 2008;107:1–14.
Fabre Demard N, Boulet P, Prat X, Charra L, Lesnik A, Taourel P. [Breast MRI in invasive lobular carcinoma: diagnosis and staging]. J Radiol. 2005;86:1027–34.
Schelfout K, Van Goethem M, Kersschot E, Verslegers I, Biltjes I, Leyman P, et al. Preoperative breast MRI in patients with invasive lobular breast cancer. Eur Radiol. 2004;14:1209–16.
Diekmann F, Diekmann S, Beljavskaja M, Bick U, Taupitz M, Blohmer JU, et al. [Preoperative MRT of the breast in invasive lobular carcinoma in comparison with invasive ductal carcinoma]. Rofo. 2004;176:544–9.
Berg WA, Gutierrez L, NessAiver MS, Carter WB, Bhargavan M, Lewis RS, et al. Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology. 2004;233:830–49.
Jatoi I, Proschan MA. Randomized trials of breast-conserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results. Am J Clin Oncol. 2005;28:289–94.
Cochrane RA, Valasiadou P, Wilson AR, Al-Ghazal SK, Macmillan RD. Cosmesis and satisfaction after breast-conserving surgery correlates with the percentage of breast volume excised. Br J Surg. 2003;90:1505–9.
Krishnan L, Stanton AL, Collins CA, Liston VE, Jewell WR. Form or function? Part 2. Objective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy. Cancer. 2001;91:2282–7.
Mann RM, Loo CE, Wobbes T, Bult P, Barentsz JO, Gilhuijs KG, et al., The impact of preoperative breast MRI on the re-excision rate in invasive lobular carcinoma of the breast. Breast Cancer Res Treat. 2010;119:415–22.
Pengel KE, Loo CE, Teertstra HJ, Muller SH, Wesseling J, Peterse JL, et al. The impact of preoperative MRI on breast-conserving surgery of invasive cancer: a comparative cohort study. Breast Cancer Res Treat. 2009;116:161–9.
Hussien M, Lioe TF, Finnegan J, Spence RA. Surgical treatment for invasive lobular carcinoma of the breast. Breast. 2003;12:23–35.
O’Sullivan MJ, Li T, Freedman G, Morrow M. The effect of multiple reexcisions on the risk of local recurrence after breast conserving surgery. Ann Surg Oncol. 2007;14:3133–40.
van den Broek N, van der Sangen MJ, van de Poll-Franse LV, van Beek MW, Nieuwenhuijzen GA, Voogd AC. Margin status and the risk of local recurrence after breast-conserving treatment of lobular breast cancer. Breast Cancer Res Treat. 2007;105:63–8.
Morrow M, Keeney K, Scholtens D, Wei J, Steel J, Khan SA. Selecting patients for breast-conserving therapy: the importance of lobular histology. Cancer. 2006;106:2563–8.
Dillon MF, Hill AD, Fleming FJ, O’Doherty A, Quinn CM, McDermott EW, et al. Identifying patients at risk of compromised margins following breast conservation for lobular carcinoma. Am J Surg. 2006;191:201–5.
Liberman L, Morris EA, Kim CM, Kaplan JB, Abramson AF, Menell JH, et al. MR imaging findings in the contralateral breast of women with recently diagnosed breast cancer. AJR Am J Roentgenol. 2003;180:333–41.
Lehman CD, Gatsonis C, Kuhl CK, Hendrick RE, Pisano ED, Hanna L, et al. MRI evaluation of the contralateral breast in women with recently diagnosed breast cancer. N Engl J Med. 2007;356:1295–303.
Yeatman TJ, Cantor AB, Smith TJ, Smith SK, Reintgen DS, Miller MS, et al. Tumor biology of infiltrating lobular carcinoma. Implications for management. Ann Surg. 1995;222:549–59; discussion 559–61.
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There are no conflicts of interests (e.g. employment, consultancies, stock ownership, honoraria, paid expert testimony, patent applications/registrations, and grants or other funding) by any of the authors.
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Heil, J., Bühler, A., Golatta, M. et al. Does a Supplementary Preoperative Breast MRI in Patients with Invasive Lobular Breast Cancer Change Primary and Secondary Surgical Interventions?. Ann Surg Oncol 18, 2143–2149 (2011). https://doi.org/10.1245/s10434-011-1565-y
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DOI: https://doi.org/10.1245/s10434-011-1565-y