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Role of Preoperative Magnetic Resonance Imaging in the Surgical Management of Early-Stage Breast Cancer

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

Abstract

Purpose

To examine the role of preoperative magnetic resonance imaging (pMRI) on time to surgery and rates of reoperation and contralateral prophylactic mastectomy (CPM) using a population-based study of New Jersey breast cancer patients.

Methods

The study included 289 African-American and 320 white women who participated in the Breast Cancer Treatment Disparity Study and underwent breast surgery for newly diagnosed early-stage breast cancer between 2005 and 2010. Patients were identified through rapid case ascertainment by the New Jersey State Cancer Registry. Association between pMRI and time to surgery was examined by using linear regression and, with reoperation and CPM, by using binomial regression.

Results

Half (49.9 %) of the study population received pMRI, with higher use for whites compared with African-Americans (62.5 vs. 37.5 %). After adjusting for potential confounders, patients with pMRI versus those without experienced significantly longer time to initial surgery [geometric mean = 38.7 days; 95 % confidence interval (CI) 34.8–43.0; vs. 26.5 days; 95 % CI 24.3–29.0], a significantly higher rate of CPM [relative risk (RR) = 1.82; 95 % CI 1.06–3.12], and a nonsignificantly lower rate of reoperation (RR = 0.76; 95 % CI 0.54–1.08).

Conclusions

Preoperative MRI was associated with significantly increased time to surgery and a higher rate of CPM, but it did not affect the rate of reoperation. Physicians and patients should consider these findings when making surgical decisions on the basis of pMRI findings.

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Acknowledgment

This work was supported by Grants from the American Cancer Society (RSGT-07-291-01-CPHPS), the Susan G. Komen Breast Cancer Foundation (POP131006), the National Cancer Institute (R01CA133264, R01 CA100598, P01 CA151135, K22 CA138563, P30CA072720, and P30 CA016056), US Army Medical Research and Material Command (DAMD-17-01-1-0334), the Breast Cancer Research Foundation, and a gift from the Philip L. Hubbell family and the Buckingham Foundation. The funding agencies played no role in study design; collection, analysis, and interpretation of data; and writing of the manuscript and decision to submit the manuscript for publication. The study team is grateful for medical, surgical, and radiation oncologists and primary care physicians who understood the value of research and helped us obtain the medical records of patients without which the conduct of the study would have been impossible.

Disclosure

No potential conflicts of interest.

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Authors and Affiliations

  1. Department of Epidemiology, Rutgers School of Public Health, Piscataway, NJ, USA

    Sheenu Chandwani PhD, Prethibha A. George PhD, Michelle Azu MD, Elisa V. Bandera MD, PhD, George G. Rhoads MD, MPH & Kitaw Demissie MD, PhD

  2. Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Sheenu Chandwani PhD, Elisa V. Bandera MD, PhD, George G. Rhoads MD, MPH & Kitaw Demissie MD, PhD

  3. Institute for the Elimination of Health Disparities, Newark, NJ, USA

    Sheenu Chandwani PhD & Kitaw Demissie MD, PhD

  4. Chilton Hospital, Pompton Plains, NJ, USA

    Michelle Azu MD

  5. Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA

    Christine B. Ambrosone PhD

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  1. Sheenu Chandwani PhD
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  2. Prethibha A. George PhD
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  3. Michelle Azu MD
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  4. Elisa V. Bandera MD, PhD
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  6. George G. Rhoads MD, MPH
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Correspondence to Sheenu Chandwani PhD.

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Chandwani, S., George, P.A., Azu, M. et al. Role of Preoperative Magnetic Resonance Imaging in the Surgical Management of Early-Stage Breast Cancer. Ann Surg Oncol 21, 3473–3480 (2014). https://doi.org/10.1245/s10434-014-3748-9

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  • DOI: https://doi.org/10.1245/s10434-014-3748-9

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