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Limited Value and Utility of Breast MRI in Patients Undergoing Breast-Conserving Cancer Surgery

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Our aim was to compare the accuracy of magnetic resonance imaging (MRI) and ultrasonography (US) in measuring the size of invasive breast cancer (IBC) and carcinoma in situ (CIS). We also examined the utility of routinely performing MRI in addition to US before breast-conserving surgery (BCS).

Patients and Methods

Data from 1558 consecutive patients diagnosed with IBC and/or CIS between 2003 and 2005 were reviewed. For comparing the accuracy of US and MRI, paired t test was done comparing pathologic and imaging (US and MRI) tumor size in 821 patients who received both breast US and MRI. In instance of attempted BCS (n = 794), operative approach, resection margins, and clinical outcomes of non-MRI and MRI groups were compared.

Results

For CIS, IBC without CIS, and IBC with CIS, MRI was more accurate in estimating tumor size than US. When BCS was attempted (n = 794), the rate of tumor involvement in initial resection margins did not differ between non-MRI and MRI groups (23.0% and 23.4%, P = .926). Similarly, rates of re-excision (13.1% vs 17.5%, P = .130) and conversion to mastectomy (2.3% vs 2.1%, P = .893) were comparable, as were ipsilateral breast tumor recurrence, locoregional recurrence, and disease-free survival (log rank P = .284, .950, and .955, respectively).

Conclusions

Breast MRI provided more accurate estimates of tumor size, correlating better with pathologic tumor size than US for both IBC and CIS. However, no clear benefit in terms of lower re-excision rate, higher breast conservation success, or reduced recurrence emerged for routine use of breast MRI before BCS.

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Acknowledgment

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science, and Technology (2010-0004148, 2011-0005753).

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Authors and Affiliations

  1. Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

    Hee-Chul Shin MD, Wonshik Han MD, PhD, Hyeong-Gon Moon MD, Soo Kyung Ahn MD, Jee-Man You MD, Ji Sun Kim MD & Dong-Young Noh MD, PhD

  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

    Wonshik Han MD, PhD & Dong-Young Noh MD, PhD

  3. Department of Surgery, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea

    Cha Kyong Yom MD, PhD

  4. Department of Radiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

    Jung-Min Chang MD, PhD, Nariya Cho MD, PhD & Woo Kyung Moon MD, PhD

  5. Department of Pathology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Korea

    In-Ae Park MD, PhD

Authors
  1. Hee-Chul Shin MD
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  2. Wonshik Han MD, PhD
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  3. Hyeong-Gon Moon MD
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  4. Cha Kyong Yom MD, PhD
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  6. Jee-Man You MD
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  7. Ji Sun Kim MD
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  8. Jung-Min Chang MD, PhD
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  9. Nariya Cho MD, PhD
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  10. Woo Kyung Moon MD, PhD
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  11. In-Ae Park MD, PhD
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  12. Dong-Young Noh MD, PhD
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Corresponding author

Correspondence to Dong-Young Noh MD, PhD.

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Shin, HC., Han, W., Moon, HG. et al. Limited Value and Utility of Breast MRI in Patients Undergoing Breast-Conserving Cancer Surgery. Ann Surg Oncol 19, 2572–2579 (2012). https://doi.org/10.1245/s10434-012-2289-3

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  • DOI: https://doi.org/10.1245/s10434-012-2289-3

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