Breast Cancer Research and Treatment

, Volume 153, Issue 3, pp 531–537 | Cite as

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

  • Manuel Debald
  • Alina Abramian
  • Lisa Nemes
  • Michael Döbler
  • Christina Kaiser
  • Mignon-Denise Keyver-Paik
  • Claudia Leutner
  • Tobias Höller
  • Michael Braun
  • Christiane Kuhl
  • Walther Kuhn
  • Hans H. Schild
Clinical Trial


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.


Breast cancer MRI Surgery Preoperative management 


Compliance with ethical standards

Conflict of interest

The authors declare that there are no conflicts of interest.


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Manuel Debald
    • 1
  • Alina Abramian
    • 1
  • Lisa Nemes
    • 1
  • Michael Döbler
    • 1
  • Christina Kaiser
    • 1
  • Mignon-Denise Keyver-Paik
    • 1
  • Claudia Leutner
    • 2
  • Tobias Höller
    • 3
  • Michael Braun
    • 1
    • 4
  • Christiane Kuhl
    • 5
  • Walther Kuhn
    • 1
  • Hans H. Schild
    • 2
  1. 1.Department of Obstetrics and Gynecology, Centre for Integrated Oncology (CIO)University of BonnBonnGermany
  2. 2.Department of Radiology, Centre for Integrated OncologyUniversity of BonnBonnGermany
  3. 3.Institute for Medical Biometry, Informatics and Epidemiology (IMBIE)University of BonnBonnGermany
  4. 4.Department of GynecologyRed Cross Women’s Clinic MunichMunichGermany
  5. 5.Department of Diagnostic and Interventional RadiologyUniversity of Aachen RWTHAachenGermany

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