Breast magnetic resonance imaging use in patients undergoing neoadjuvant chemotherapy is associated with less mastectomies in large ductal cancers but not in lobular cancers

Ingeborg J.H. Vriens, Kristien Keymeulen, Marc B.I. Lobbes, Annelotte C.M. van Bommel, Grard A.P. Nieuwenhuijzen, Marjolein L. Smidt, Liesbeth J. Boersma, Thijs van Dalen, Carolien H. Smorenburg, Henk Struikmans, Sabine Siesling, Adri C. Voogd, Vivianne C.G. Tjan-Heijnen*,

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background To assess the impact of breast magnetic resonance imaging (MRI) use on surgical outcome per histological breast cancer subtype in patients treated with neoadjuvant chemotherapy. Patients and methods All patients aged 18–70 years who underwent neoadjuvant chemotherapy for stage I–III invasive breast cancer in the Netherlands in the years 2011–2013 were identified from the Netherlands Cancer Registry. Patients with cT4 tumours were excluded from the analysis. Use of breast MRI and impact on surgical treatment, resection margins and detection of contralateral breast cancer were analysed by multivariable analyses. Results Breast MRI was performed in 2879 (83.9%) out of 3433 patients treated with neoadjuvant chemotherapy. Younger age (odds ratio [OR] 1.42; 95% confidence interval [CI] 1.17–1.71 for 18–50 years compared with 50–70 years), larger tumour stage (OR 1.46 [95% CI 1.15–1.86] for cT3, compared to cT1–2 tumours) and multifocality (OR 1.30; 95% CI 1.04–1.61, versus unifocality) were associated with increased breast MRI use. In ductal breast cancer, after stratification for cT-status, breast MRI use is associated with a significant lower OR for mastectomy as final surgery in cT3 tumours (OR 0.45, 95% CI 0.21–0.99). Resection margin involvement and detection of contralateral breast cancer were not associated with breast MRI use. Conclusion In patients treated with neoadjuvant chemotherapy, the use of breast MRI was associated with a reduced mastectomy rate, particularly in patients with large invasive ductal breast tumours but not in patients with lobular breast cancer.

Original languageEnglish
Pages (from-to)74-80
Number of pages7
JournalEuropean journal of cancer
Volume81
DOIs
Publication statusPublished - 1 Aug 2017

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Mastectomy
Breast
Magnetic Resonance Imaging
Drug Therapy
Breast Neoplasms
Odds Ratio
Neoplasms
Confidence Intervals
Netherlands
Registries

Keywords

  • Breast cancer
  • Breast MRI
  • Neoadjuvant chemotherapy
  • Surgery

Cite this

Vriens, Ingeborg J.H. ; Keymeulen, Kristien ; Lobbes, Marc B.I. ; van Bommel, Annelotte C.M. ; Nieuwenhuijzen, Grard A.P. ; Smidt, Marjolein L. ; Boersma, Liesbeth J. ; van Dalen, Thijs ; Smorenburg, Carolien H. ; Struikmans, Henk ; Siesling, Sabine ; Voogd, Adri C. ; Tjan-Heijnen, Vivianne C.G. / Breast magnetic resonance imaging use in patients undergoing neoadjuvant chemotherapy is associated with less mastectomies in large ductal cancers but not in lobular cancers. In: European journal of cancer. 2017 ; Vol. 81. pp. 74-80.
@article{d2f32c3c23d940cf89c3b45777ccc47f,
title = "Breast magnetic resonance imaging use in patients undergoing neoadjuvant chemotherapy is associated with less mastectomies in large ductal cancers but not in lobular cancers",
abstract = "Background To assess the impact of breast magnetic resonance imaging (MRI) use on surgical outcome per histological breast cancer subtype in patients treated with neoadjuvant chemotherapy. Patients and methods All patients aged 18–70 years who underwent neoadjuvant chemotherapy for stage I–III invasive breast cancer in the Netherlands in the years 2011–2013 were identified from the Netherlands Cancer Registry. Patients with cT4 tumours were excluded from the analysis. Use of breast MRI and impact on surgical treatment, resection margins and detection of contralateral breast cancer were analysed by multivariable analyses. Results Breast MRI was performed in 2879 (83.9{\%}) out of 3433 patients treated with neoadjuvant chemotherapy. Younger age (odds ratio [OR] 1.42; 95{\%} confidence interval [CI] 1.17–1.71 for 18–50 years compared with 50–70 years), larger tumour stage (OR 1.46 [95{\%} CI 1.15–1.86] for cT3, compared to cT1–2 tumours) and multifocality (OR 1.30; 95{\%} CI 1.04–1.61, versus unifocality) were associated with increased breast MRI use. In ductal breast cancer, after stratification for cT-status, breast MRI use is associated with a significant lower OR for mastectomy as final surgery in cT3 tumours (OR 0.45, 95{\%} CI 0.21–0.99). Resection margin involvement and detection of contralateral breast cancer were not associated with breast MRI use. Conclusion In patients treated with neoadjuvant chemotherapy, the use of breast MRI was associated with a reduced mastectomy rate, particularly in patients with large invasive ductal breast tumours but not in patients with lobular breast cancer.",
keywords = "Breast cancer, Breast MRI, Neoadjuvant chemotherapy, Surgery",
author = "Vriens, {Ingeborg J.H.} and Kristien Keymeulen and Lobbes, {Marc B.I.} and {van Bommel}, {Annelotte C.M.} and Nieuwenhuijzen, {Grard A.P.} and Smidt, {Marjolein L.} and Boersma, {Liesbeth J.} and {van Dalen}, Thijs and Smorenburg, {Carolien H.} and Henk Struikmans and Sabine Siesling and Voogd, {Adri C.} and Tjan-Heijnen, {Vivianne C.G.}",
year = "2017",
month = "8",
day = "1",
doi = "10.1016/j.ejca.2017.05.012",
language = "English",
volume = "81",
pages = "74--80",
journal = "European journal of cancer",
issn = "0959-8049",
publisher = "Elsevier",

}

Vriens, IJH, Keymeulen, K, Lobbes, MBI, van Bommel, ACM, Nieuwenhuijzen, GAP, Smidt, ML, Boersma, LJ, van Dalen, T, Smorenburg, CH, Struikmans, H, Siesling, S, Voogd, AC, Tjan-Heijnen, VCG 2017, 'Breast magnetic resonance imaging use in patients undergoing neoadjuvant chemotherapy is associated with less mastectomies in large ductal cancers but not in lobular cancers', European journal of cancer, vol. 81, pp. 74-80. https://doi.org/10.1016/j.ejca.2017.05.012

Breast magnetic resonance imaging use in patients undergoing neoadjuvant chemotherapy is associated with less mastectomies in large ductal cancers but not in lobular cancers. / Vriens, Ingeborg J.H.; Keymeulen, Kristien; Lobbes, Marc B.I.; van Bommel, Annelotte C.M.; Nieuwenhuijzen, Grard A.P.; Smidt, Marjolein L.; Boersma, Liesbeth J.; van Dalen, Thijs; Smorenburg, Carolien H.; Struikmans, Henk; Siesling, Sabine; Voogd, Adri C.; Tjan-Heijnen, Vivianne C.G.

In: European journal of cancer, Vol. 81, 01.08.2017, p. 74-80.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Breast magnetic resonance imaging use in patients undergoing neoadjuvant chemotherapy is associated with less mastectomies in large ductal cancers but not in lobular cancers

AU - Vriens, Ingeborg J.H.

AU - Keymeulen, Kristien

AU - Lobbes, Marc B.I.

AU - van Bommel, Annelotte C.M.

AU - Nieuwenhuijzen, Grard A.P.

AU - Smidt, Marjolein L.

AU - Boersma, Liesbeth J.

AU - van Dalen, Thijs

AU - Smorenburg, Carolien H.

AU - Struikmans, Henk

AU - Siesling, Sabine

AU - Voogd, Adri C.

AU - Tjan-Heijnen, Vivianne C.G.

PY - 2017/8/1

Y1 - 2017/8/1

N2 - Background To assess the impact of breast magnetic resonance imaging (MRI) use on surgical outcome per histological breast cancer subtype in patients treated with neoadjuvant chemotherapy. Patients and methods All patients aged 18–70 years who underwent neoadjuvant chemotherapy for stage I–III invasive breast cancer in the Netherlands in the years 2011–2013 were identified from the Netherlands Cancer Registry. Patients with cT4 tumours were excluded from the analysis. Use of breast MRI and impact on surgical treatment, resection margins and detection of contralateral breast cancer were analysed by multivariable analyses. Results Breast MRI was performed in 2879 (83.9%) out of 3433 patients treated with neoadjuvant chemotherapy. Younger age (odds ratio [OR] 1.42; 95% confidence interval [CI] 1.17–1.71 for 18–50 years compared with 50–70 years), larger tumour stage (OR 1.46 [95% CI 1.15–1.86] for cT3, compared to cT1–2 tumours) and multifocality (OR 1.30; 95% CI 1.04–1.61, versus unifocality) were associated with increased breast MRI use. In ductal breast cancer, after stratification for cT-status, breast MRI use is associated with a significant lower OR for mastectomy as final surgery in cT3 tumours (OR 0.45, 95% CI 0.21–0.99). Resection margin involvement and detection of contralateral breast cancer were not associated with breast MRI use. Conclusion In patients treated with neoadjuvant chemotherapy, the use of breast MRI was associated with a reduced mastectomy rate, particularly in patients with large invasive ductal breast tumours but not in patients with lobular breast cancer.

AB - Background To assess the impact of breast magnetic resonance imaging (MRI) use on surgical outcome per histological breast cancer subtype in patients treated with neoadjuvant chemotherapy. Patients and methods All patients aged 18–70 years who underwent neoadjuvant chemotherapy for stage I–III invasive breast cancer in the Netherlands in the years 2011–2013 were identified from the Netherlands Cancer Registry. Patients with cT4 tumours were excluded from the analysis. Use of breast MRI and impact on surgical treatment, resection margins and detection of contralateral breast cancer were analysed by multivariable analyses. Results Breast MRI was performed in 2879 (83.9%) out of 3433 patients treated with neoadjuvant chemotherapy. Younger age (odds ratio [OR] 1.42; 95% confidence interval [CI] 1.17–1.71 for 18–50 years compared with 50–70 years), larger tumour stage (OR 1.46 [95% CI 1.15–1.86] for cT3, compared to cT1–2 tumours) and multifocality (OR 1.30; 95% CI 1.04–1.61, versus unifocality) were associated with increased breast MRI use. In ductal breast cancer, after stratification for cT-status, breast MRI use is associated with a significant lower OR for mastectomy as final surgery in cT3 tumours (OR 0.45, 95% CI 0.21–0.99). Resection margin involvement and detection of contralateral breast cancer were not associated with breast MRI use. Conclusion In patients treated with neoadjuvant chemotherapy, the use of breast MRI was associated with a reduced mastectomy rate, particularly in patients with large invasive ductal breast tumours but not in patients with lobular breast cancer.

KW - Breast cancer

KW - Breast MRI

KW - Neoadjuvant chemotherapy

KW - Surgery

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U2 - 10.1016/j.ejca.2017.05.012

DO - 10.1016/j.ejca.2017.05.012

M3 - Article

C2 - 28618304

AN - SCOPUS:85020460866

VL - 81

SP - 74

EP - 80

JO - European journal of cancer

JF - European journal of cancer

SN - 0959-8049

ER -