title: The impact of preoperative breast MRI on the re-excision rate in invasive lobular carcinoma of the breast.
abstract: Re-excision rates after breast conserving surgery(BCS) of invasive lobular carcinoma (ILC) are high.Preoperative breast MRI has the potential to reduce re-excision rates, but may lead to an increased rate of mastectomies. Hence, we assessed the influence of preoperative breast MRI on the re-excision rate and the rate of mastectomies. We performed a retrospective cohort study of a consecutive series of patients with ILC who presented in one of two dedicated tertiary cancer centers between 1993 and 2005. We assessed the initial type of surgery(BCS or mastectomy), the re-excision rate and the final type of surgery. Patients were stratified into two groups:those who received preoperative MRI (MR? group) and those who did not (MR- group). In the MR- group, 27%of the patients underwent a re-excision after initial BCS. In the MR? group, this rate was significantly lower at 9%.The odds ratio was 3.64 (95% CI: 1.30-10.20, P = 0.010).There was a trend towards a lower final mastectomy rate in the MR? group compared to the MR- group (48 vs. 59%,P = 0.098). In conclusion, preoperative MRI in patients with ILC can reduce re-excision rates without increasing the rate of mastectomies.
authors.affiliation: Department of Radiology, Radboud University Nijmegen, Medical Centre, huispost 667, Geert Grooteplein 10, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands. r.mann@rad.umcn.nl
authors.forename: R M
authors.initials: RM
authors.lastname: Mann
authors.forename: C E
authors.initials: CE
authors.lastname: Loo
authors.forename: T
authors.initials: T
authors.lastname: Wobbes
authors.forename: P
authors.initials: P
authors.lastname: Bult
authors.forename: J O
authors.initials: JO
authors.lastname: Barentsz
authors.forename: K G A
authors.initials: KG
authors.lastname: Gilhuijs
authors.forename: C
authors.initials: C
authors.lastname: Boetes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018275:Carcinoma, Lobular / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009426:Netherlands; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome