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Title
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Preoperative breast MRI positively impacts surgical outcomes of needle biopsy-diagnosed pure DCIS : a patient-matched analysis from the MIPA study
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Author
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Abstract
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| Objectives: To investigate the influence of preoperative breast MRI on mastectomy and reoperation rates in patients with pure ductal carcinoma in situ (DCIS).Methods: The MIPA observational study database (7245 patients) was searched for patients aged 18-80 years with pure unilateral DCIS diagnosed at core needle or vacuum-assisted biopsy (CNB/VAB) and planned for primary surgery. Patients who underwent preoperative MRI (MRI group) were matched (1:1) to those who did not receive MRI (noMRI group) according to 8 confounding covariates that drive referral to MRI (age; hormonal status; familial risk; posterior-to-nipple diameter; BI-RADS category; lesion diameter; lesion presentation; surgical planning at conventional imaging). Surgical outcomes were compared between the matched groups with nonparametric statistics after calculating odds ratios (ORs).Results: Of 1005 women with pure unilateral DCIS at CNB/VAB (507 MRI group, 498 noMRI group), 309 remained in each group after matching. First-line mastectomy rate in the MRI group was 20.1% (62/309 patients, OR 2.03) compared to 11.0% in the noMRI group (34/309 patients, p = 0.003). The reoperation rate was 10.0% in the MRI group (31/309, OR for reoperation 0.40) and 22.0% in the noMRI group (68/309, p < 0.001), with a 2.53 OR of avoiding reoperation in the MRI group. The overall mastectomy rate was 23.3% in the MRI group (72/309, OR 1.40) and 17.8% in the noMRI group (55/309, p = 0.111).Conclusions: Compared to those going directly to surgery, patients with pure DCIS at CNB/VAB who underwent preoperative MRI had a higher OR for first-line mastectomy but a substantially lower OR for reoperation. |
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Language
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English
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Source (journal)
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European radiology. - Secaucus, N.J., 1991, currens
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Publication
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New york
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Springer
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2024
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ISSN
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0938-7994
[print]
1432-1084
[online]
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DOI
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10.1007/S00330-023-10409-5
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Volume/pages
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34
(2024)
, p. 3970-3980
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ISI
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001109541800004
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Pubmed ID
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37999727
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Full text (Publisher's DOI)
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Full text (open access)
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