Pre-op MRI reveals additional malignant lesions in up to 25% of breast cancer patients under 40
Preoperative breast MRI scans often reveal additional lesions, which may alter surgical plans in a significant number of patients.
This is especially true for women younger than 40, according to new data published in Clinical Imaging this week. Findings from the study suggest up to half of preoperative breast MRIs on women who have been diagnosed with breast cancer reveal additional lesions that warrant a biopsy. These findings could have real implications for outcomes in younger women, as they could alter how providers manage their care, authors of the paper suggested.
“Recent epidemiological trends indicate a rising incidence of breast cancer among younger women, who often present with more aggressive tumor phenotypes and poorer prognoses compared to older patients,” Tugce Erguven, with the George Washington University School of Medicine and Health Sciences in Washington, D.C., and colleagues explained. “Despite this, limited research has focused on the impact of preoperative MRI on surgical decision-making in this demographic.”
To get a better understanding of how pre-op MRI affects care in women under 40, the team retrospectively analyzed the cases of 125 women who were diagnosed with breast cancer at a university academic practice between January 2015 and December 2020. Each underwent an MRI prior to surgery and had available follow-up data on their individual risk factors, imaging findings and surgical outcomes.
MRI led to additional findings warranting biopsy in nearly 54% of the women. Of those, 45.5% had lesions that were confirmed as malignant; 24 were in the ipsilateral breast, while 1 was contralateral. The team estimated that those with additional malignant findings were over six times more likely to require a mastectomy compared to those who did not have secondary lesions. Of note, 82% of the cohort had dense breast tissue.
“Preoperative MRI in women aged 40 years and younger with breast cancer significantly increases the detection of additional malignant sites of disease, leading to changes in surgical management,” the authors noted. “Given the aggressive nature of breast cancer in this demographic, preoperative MRI should be considered as a standard component of the diagnostic workup to ensure optimal surgical outcomes.”
The team acknowledged their findings do not offer insight into long-term outcomes; they suggested future studies focus on this to determine how surgical adjustments prompted by MRI findings affect overall survival rates.
Read more here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.