title: Locoregional treatment of breast cancer in women with and without preoperative magnetic resonance imaging.
abstract: BACKGROUND
  Preoperative magnetic resonance imaging (MRI) use has increased among older women diagnosed with breast cancer. MRI detects additional malignancy, but its impact on locoregional surgery and radiation treatment remains unclear.
  
  
  METHODS
  We examined the associations of preoperative MRI with initial locoregional treatment type (mastectomy, breast conserving surgery [BCS] with radiation therapy [RT], and BCS without RT) and BCS reoperation rates for Surveillance, Epidemiology, and End Results Medicare women diagnosed with stages 0 to III breast cancer from 2005 to 2009 (n = 55,997).
  
  
  RESULTS
  We found no association of initial locoregional treatment of mastectomy (odds ratios [OR], 1.04; 95% confidence intervals, .98 to 1.11) or reoperation after initial BCS (OR, .96; 95% confidence intervals, .89 to 1.03) between women with preoperative MRI (16.2%) compared to women without MRI. However, women with MRI who had initial BCS were more likely to undergo RT (OR, 1.09 [1.02 to 1.16]).
  
  
  CONCLUSIONS
  Preoperative breast MRI in Medicare-enrolled women with stages 0 to III breast cancer was not associated with increased mastectomy. However, in older women with MRI undergoing BCS, there was a greater use of RT.
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
authors.forename: Elissa M
authors.initials: EM
authors.lastname: Ozanne
authors.affiliation: Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 105, Lebanon, NH 03766, USA. Electronic address: julie.weiss@dartmouth.edu.
authors.forename: Julie E
authors.initials: JE
authors.lastname: Weiss
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 105, Lebanon, NH 03766, USA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Onega
authors.affiliation: Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: DeMartini
authors.affiliation: Department of Medicine, University of California, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
authors.forename: Karla
authors.initials: K
authors.lastname: Kerlikowske
authors.affiliation: Department of Epidemiology, Group Health Research Institute, Seattle, WA, USA.
authors.forename: Diana S M
authors.initials: DS
authors.lastname: Buist
authors.affiliation: Department of Radiology, The University of North Carolina, Chapel Hill, NC, USA.
authors.forename: Louise
authors.initials: L
authors.lastname: Henderson
authors.affiliation: Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Hubbard
authors.affiliation: Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, 46 Centerra Parkway, Suite 105, Lebanon, NH 03766, USA.
authors.forename: Martha
authors.initials: M
authors.lastname: Goodrich
authors.affiliation: The Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA.
authors.forename: Anna N A
authors.initials: AN
authors.lastname: Tosteson
authors.affiliation: Department of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Virnig
authors.affiliation: Department of Surgical Oncology, Surgical Oncology, Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: O'Donoghue
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000628:therapy*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008408:Mastectomy; D009367:Neoplasm Staging; D011300:Preoperative Care; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018426:SEER Program
keywords: Breast cancer; Breast conserving surgery; Mastectomy; Preoperative MRI