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The impact of preoperative MRI on breast-conserving surgery of invasive cancer: a comparative cohort study

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Abstract

Aim To assess whether preoperative contrast-enhanced magnetic resonance imaging (MRI) of the breast influences the rate of incomplete tumor excision. Methods In a cohort of 349 women with invasive breast cancer, patients eligible for breast-conserving therapy (BCT) on the basis of conventional imaging and palpation only (N = 176) were compared to those who had an additional preoperative MRI (N = 173). Multivariate analysis was applied to explore associations with incomplete tumor excision. Results MRI detected larger extent of breast cancer in 19 women (11.0%), leading to treatment change: mastectomy (8.7%) or wider excision (2.3%). Tumor excision was incomplete in 22/159 (13.8%) wide local excisions in the MRI group and in 35/180 (19.4%) in the non-MRI group (P = 0.17). Stratified to tumor type, incompletely excised infiltrating ductal carcinoma (IDC) was significantly associated with absence of MRI: 11/136 (8.1%) versus 2/126 (1.6%) (MRI present) (P = 0.02). No significant factors explained incomplete excision of other tumor types. Conclusion Preoperative MRI did not significantly affect the overall rate of incomplete tumor excision, but it yielded significantly lower rate of incompletely excised IDC. The reduction of incomplete excisions after MRI was smaller than the rate of a prior treatment change incurred by MRI.

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Acknowledgments

The authors thank Angelique Schlief, Anita Paape, Wil van Waardenberg, Eline Deurloo, Wilma Oughlane-Heemsbergen, and Robert Lindeboom for their contribution. This work was financially supported by The Dutch Cancer Foundation, grant number NKB 2004–3082

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Authors and Affiliations

  1. Department of Radiology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    K. E. Pengel, C. E. Loo, H. J. Teertstra, S. H. Muller & K. G. A. Gilhuijs

  2. Department of Pathology, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    J. Wesseling & J. L. Peterse

  3. Department of Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    E. J. Rutgers

  4. Department of Radiotherapy, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital (NKI-AVL), Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands

    H. Bartelink

Authors
  1. K. E. Pengel
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  2. C. E. Loo
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  3. H. J. Teertstra
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  4. S. H. Muller
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  5. J. Wesseling
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  6. J. L. Peterse
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  7. H. Bartelink
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  9. K. G. A. Gilhuijs
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Correspondence to K. G. A. Gilhuijs.

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J. L. Peterse was deceased.

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Pengel, K.E., Loo, C.E., Teertstra, H.J. et al. The impact of preoperative MRI on breast-conserving surgery of invasive cancer: a comparative cohort study. Breast Cancer Res Treat 116, 161–169 (2009). https://doi.org/10.1007/s10549-008-0182-3

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  • DOI: https://doi.org/10.1007/s10549-008-0182-3

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