title: Influence of preoperative magnetic resonance imaging on the surgical management of breast cancer patients.
abstract: BACKGROUND
  Magnetic resonance imaging (MRI) is gaining popularity in the preoperative management of breast cancer patients. However, the role of this modality remains controversial. We aimed to study the impact of preoperative MRI (pMRI) on the surgical management of breast cancer patients.
  
  
  METHODS
  This retrospective study included 766 subjects with breast cancer treated operatively at the specialized academic center.
  
  
  RESULTS
  Between those who underwent pMRI (MRI group, n = 307) and those who did not (no-MRI group, n = 458), there were no significant differences (P = .254) in the proportions of either total mastectomies (20.5% vs 17.2%, respectively) or segmental mastectomies (79.5% vs 82.8%). Patients in the MRI group were significantly more likely (P = .002) to undergo contralateral surgery (11.7% vs 5.5%). Similar results were obtained in multivariate analysis adjusting for age, with the proportions of contralateral breast operations significantly higher in the MRI group (Odds Ratio = 2.25, P = .007). pMRI had no significant effect (P = .54) on the proportion of total re-excisions (7.5% vs 8.7%) or the type of re-excision (total vs segmental mastectomy) between the groups.
  
  
  CONCLUSIONS
  pMRI does not have a significant impact on the type of operative intervention on the ipsilateral breast but is associated with an increase in contralateral operations. Similarly, pMRI does not change the proportion of re-excisions or the type of the re-excision performed. This study demonstrates that pMRI has little impact on the surgical management of breast cancer, and its value as a routine adjunct in the preoperative work-up of recently diagnosed breast cancer patients needs to be re-examined.
authors.affiliation: Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Armen
authors.initials: A
authors.lastname: Parsyan
authors.affiliation: Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Dan
authors.initials: D
authors.lastname: Moldoveanu
authors.affiliation: Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Bhairavi
authors.initials: B
authors.lastname: Balram
authors.affiliation: Department of Surgery, McGill University, Montreal, Quebec, Canada.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Wong
authors.affiliation: Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
authors.forename: David Dong Qi
authors.initials: DD
authors.lastname: Zhang
authors.affiliation: Cedars Breast Clinic, McGill University Health Centre, Montreal, Quebec, Canada.
authors.forename: Anita
authors.initials: A
authors.lastname: Svadzian
authors.affiliation: Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Allard-Coutu
authors.affiliation: Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
authors.forename: Megan
authors.initials: M
authors.lastname: Delisle
authors.affiliation: Cedars Breast Clinic, McGill University Health Centre, Montreal, Quebec, Canada; Department of Radiology, McGill University, Montreal, Quebec, Canada.
authors.forename: Benoit
authors.initials: B
authors.lastname: Mesurolle
authors.affiliation: Department of Surgery, McGill University, Montreal, Quebec, Canada; Cedars Breast Clinic, McGill University Health Centre, Montreal, Quebec, Canada; Department of Oncology, McGill University, Montreal, Quebec, Canada. Electronic address: sarkis.meterissian@muhc.mcgill.ca.
authors.forename: Sarkis
authors.initials: S
authors.lastname: Meterissian
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D002170:Canada; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007430:Intraoperative Care / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods*; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery; D011379:Prognosis; D012044:Regression Analysis; D012086:Reoperation / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Breast cancer; Conservation treatment; Magnetic resonance imaging; Mastectomy; Surgical decision making