Annals of Surgical Oncology

, Volume 19, Issue 8, pp 2572–2579 | Cite as

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

  • Hee-Chul Shin
  • Wonshik Han
  • Hyeong-Gon Moon
  • Cha Kyong Yom
  • Soo Kyung Ahn
  • Jee-Man You
  • Ji Sun Kim
  • Jung-Min Chang
  • Nariya Cho
  • Woo Kyung Moon
  • In-Ae Park
  • Dong-Young Noh
Breast Oncology

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.

Keywords

Invasive Breast Cancer Breast Magnetic Resonance Imaging Preoperative Magnetic Resonance Imaging Ipsilateral Breast Tumor Recurrence Mastectomy Rate 

Notes

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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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Hee-Chul Shin
    • 1
  • Wonshik Han
    • 1
    • 2
  • Hyeong-Gon Moon
    • 1
  • Cha Kyong Yom
    • 3
  • Soo Kyung Ahn
    • 1
  • Jee-Man You
    • 1
  • Ji Sun Kim
    • 1
  • Jung-Min Chang
    • 4
  • Nariya Cho
    • 4
  • Woo Kyung Moon
    • 4
  • In-Ae Park
    • 5
  • Dong-Young Noh
    • 1
    • 2
  1. 1.Department of Surgery, Seoul National University College of MedicineSeoul National University HospitalSeoulKorea
  2. 2.Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  3. 3.Department of Surgery, Seoul National University College of MedicineSeoul National University Bundang HospitalSeongnamKorea
  4. 4.Department of Radiology, Seoul National University College of MedicineSeoul National University HospitalSeoulKorea
  5. 5.Department of Pathology, Seoul National University College of MedicineSeoul National University HospitalSeoulKorea

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