title: Yield of selective magnetic resonance imaging in preoperative workup of newly diagnosed breast cancer patients planned for breast conserving surgery.
abstract: The role of routine preoperative magnetic resonance imaging (MRI) in newly diagnosed breast cancer patients planned for breast conserving surgery is presently being debated. In our medical center we practice selective use of preoperative MRI; we sought to examine the yield of MRI in  this highly selected group of patients. A retrospective study of all newly diagnosed breast cancer patients presenting between January 2007 and July 2010 to the Tel Aviv Sourasky Medical Center (Tel Aviv, Israel) was completed. Patients planned for breast conserving surgery who underwent preoperative  MRI were included in this study. Patients and tumor characteristics, indication for MRI, findings on MRI, consequent workup, and impact on surgical treatment were recorded. Association between preoperative characteristics and yield of MRI was examined. During the study period, 105 patients  that were candidates for breast conserving surgery underwent preoperative evaluation with MRI. Use of breast MRI increased over time. Rates of mastectomy were stable throughout the study years. Dense mammogram was the most frequent (51, 68%) indication for MRI. Additional suspicious findings  were found in 41 (39%) patients, prompting further workup including 36 biopsies in 25 patients, of which 22 (61%) were with cancer. These additional findings prompted a change in the surgical plan in a third of the patients. In most patients (92; 88%) clear margins were achieved. Limiting  the use of MRI in the preoperative workup of breast cancer patients to a selected group of patients can increase the yield of MRI.
authors.affiliation: Department of Surgery, Sourasky Medical Center, Tel Aviv, Israel. tehillahm@tasmc.health.gov.il
authors.forename: Tehillah S
authors.initials: TS
authors.lastname: Menes
authors.forename: Sivan
authors.initials: S
authors.lastname: Zissman
authors.forename: Orit
authors.initials: O
authors.lastname: Golan
authors.forename: Fani
authors.initials: F
authors.lastname: Sperber
authors.forename: Joseph
authors.initials: J
authors.lastname: Klausner
authors.forename: Schlomo
authors.initials: S
authors.lastname: Schneebaum
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000601:surgery; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D015412:Mastectomy, Segmental; D008875:Middle Aged; D018299:Neoplasms, Ductal, Lobular, and Medullary / Q000175:diagnosis* / Q000601:surgery; D011300:Preoperative Care; D012189:Retrospective Studies; D016896:Treatment Outcome