Pre-op MRI not necessary for all breast cancer patients, new data suggest
Preoperative breast MRI exams may not be necessary for all breast cancer patients, new data suggest.
Presented this week during the San Antonio Breast Cancer Symposium (SABCS), the study signals that most women who have been diagnosed with stage 1 or 2 hormone receptor (HR)-negative cancers do not benefit from the added imaging. Although pre-op breast MRIs are often utilized to ensure providers have a thorough understanding of the extent of a patient’s disease, the findings indicate this specific cohort of women has similar five-year outcomes regardless of whether they complete the exam prior to surgery.
In some cases, it may actually be more beneficial for these women to forego the extra scans, as they can lead to additional testing, costs and potentially delays in care, the study’s lead investigator Isabelle Bedrosian, MD, a surgical oncologist and professor of breast surgical oncology at The University of Texas MD Anderson Cancer Center, cautions.
“These costs and delays could be justified if there were demonstrable improvement in patient outcomes associated with the use of MRI, but its impact on oncologic outcomes has been understudied,” Bedrosian said in a announcement on the findings. “For years, the underlying assumption has been that detecting additional disease by MRI, so that it can be surgically removed, was an important way to reduce the risk of disease recurrence. We designed the clinical trial to test that assumption, setting out to determine whether detecting and removing areas of disease not detected by mammography translated to improved long-term outcomes.”
For their work, Bedrosian and colleagues studied the cases of 319 women with newly diagnosed stage 1 or 2, HR-negative breast cancer who were lumpectomy eligible and had no BRCA mutations, bilateral breast cancer or a previous history of breast cancer. At the start of the trial, participants were randomly divided into two groups—one that completed a preoperative MRI and one that did not—to determine whether long-term outcomes differed between the cohorts.
Using five years' worth of follow-up data, the group determined that the long-term outcomes between both groups were similar, with 93.2% of the MRI arm and 95.7% of the no MRI arm remaining free of locoregional recurrence. The five-year distant recurrence-free survival rates were even more similar (both around 94%), as were the overall survival rates (92.9% with MRI and 94.1% without).
“Our results further imply that there is no clinical utility to using preoperative MRI for the diagnostic workup of breast cancer patients to guide surgical treatment,” Bedrosian noted. “We conclude that the routine use of MRI in this context is not warranted.”
It should again be noted that these findings are specific to stage 1 and 2 HR-negative cancers. It is also worth highlighting that the mean age of the women participating in this trial was 58.9 years at the time of enrollment.
Learn more about the findings 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.