title: Preoperative Magnetic Resonance Imaging in Patients With Stage I Invasive Ductal Breast Cancer: A Prospective Randomized Study.
abstract: OBJECTIVE
  Preoperative magnetic resonance imaging has become an important complementary imaging technique in patients with breast cancer, providing additional information for preoperative local staging. Magnetic resonance imaging is recommended selectively in lobular breast cancer and in patients with dense breast tissue in the case when mammography and ultrasound fail to fully evaluate the lesion, but the routine use of magnetic resonance imaging in all patients with invasive ductal carcinoma is controversial. The purpose of this randomized study was to investigate the diagnostic value of preoperative magnetic resonance imaging and its impact on short-term surgical outcome in newly diagnosed unifocal stage I invasive ductal carcinoma.
  
  
  METHODS
  A total of 100 patients were randomized to either receive preoperative breast magnetic resonance imaging or to be scheduled directly to operation without magnetic resonance imaging on a 1:1 basis. There were 50 patients in both study arms.
  
  
  RESULTS
  In 14 patients (28%), breast magnetic resonance imaging detected an additional finding and seven of them were found to be malignant. Six additional cancer foci were found in the ipsilateral breast and one in the contralateral breast. Magnetic resonance imaging findings caused a change in planned surgical management in 10 patients (20%). Mastectomy was performed in six patients (12%) in the magnetic resonance imaging group and in two patients (4%) in the control group ( p = 0.140). The breast reoperation rate was 14% in the magnetic resonance imaging group and 24% in the control group ( p = 0.202). The mean interval between referral and first surgical procedure was 34 days in the magnetic resonance imaging group and 21 days in the control group ( p < 0.001).
  
  
  CONCLUSIONS
  Preoperative magnetic resonance imaging may be beneficial for some patients with early-stage invasive ductal carcinoma, but its routine use is not recommended without specific indications.
authors.affiliation: 1 Department of Plastic and General Surgery, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: N
authors.initials: N
authors.lastname: Brück
authors.affiliation: 1 Department of Plastic and General Surgery, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: I
authors.initials: I
authors.lastname: Koskivuo
authors.affiliation: 2 Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: P
authors.initials: P
authors.lastname: Boström
authors.affiliation: 3 Medical Imaging Centre of Southwest Finland, University of Turku and Turku University Hospital, Turku, Finland.|4 Department of Medical Physics, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Saunavaara
authors.affiliation: 1 Department of Plastic and General Surgery, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Aaltonen
authors.affiliation: 3 Medical Imaging Centre of Southwest Finland, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: R
authors.initials: R
authors.lastname: Parkkola
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000000981:diagnostic imaging* / Q000401:mortality / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005387:Finland; D006785:Hospitals, University; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Breast cancer; breast conserving surgery; magnetic resonance imaging; mastectomy; staging