Preoperative breast MRI can reduce the rate of tumor-positive resection margins and reoperations in patients undergoing breast-conserving surgery.
OBJECTIVE
In breast cancer patients eligible for breast-conserving surgery, we evaluated whether the information provided by preoperative MRI of the breast would result in fewer tumor-positive resection margins and fewer reoperations.


METHODS
The study group consisted of 123 consecutive patients diagnosed with either breast cancer or ductal carcinoma in situ eligible for breast-conserving surgery between April 2007 and July 2010. For these patients, a first plan for breast-conserving surgery was made on the basis of clinical examination and conventional imaging. The final surgical plan was made with knowledge of the preoperative breast MRI. The rates of tumor-positive resection margins and reoperations were compared with those of a historical control group consisting of 119 patients who underwent 123 breast-conserving procedures between January 2005 and December 2006. The percentage of change in the surgical plan was recorded.


RESULTS
Preoperative breast MRI changed the surgical plan to more extensive surgery in 42 patients (34.1%), mainly to mastectomy (29 patients, 23.6%). Ninety-four patients underwent 95 breast-conserving procedures. Significantly fewer patients had tumor-positive resection margins than in the control group (15.8%, 15/95 versus 29.3%, 36/123; p < 0.01). Patients in the study group underwent significantly fewer reoperations compared with the historical control group (18.9%, 18/95 vs 37.4%, 46/123; p < 0.01).


CONCLUSIONS
Preoperative breast MRI can substantially decrease the rate of tumor-positive resection margins and reoperations in breast cancer patients eligible for breast-conserving surgery.
Department of Radiology, Erasmus MC Rotterdam, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands. a.obdeijn@erasmusmc.nl
Inge-Marie
IM
Obdeijn
Madeleine M A
MM
Tilanus-Linthorst
Sandra
S
Spronk
Carolien H M
CH
van Deurzen
Cécile
C
de Monye
M G Myriam
MG
Hunink
Marian B E
MB
Menke
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D002278:Carcinoma in Situ / Q000473:pathology* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000473:pathology* / Q000601:surgery*; D003287:Contrast Media; D005260:Female; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009942:Organometallic Compounds; D011300:Preoperative Care; D012086:Reoperation; D018709:Statistics, Nonparametric; D013382:Subtraction Technique; D016896:Treatment Outcome
D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol