TY - JOUR
T1 - Screening and diagnostic breast MRI
T2 - how do they impact surgical treatment? Insights from the MIPA study
AU - Cozzi, Andrea
AU - Di Leo, Giovanni
AU - Houssami, Nehmat
AU - Gilbert, Fiona J.
AU - Helbich, Thomas H.
AU - Álvarez Benito, Marina
AU - Balleyguier, Corinne
AU - Bazzocchi, Massimo
AU - Bult, Peter
AU - Calabrese, Massimo
AU - Camps Herrero, Julia
AU - Cartia, Francesco
AU - Cassano, Enrico
AU - Clauser, Paola
AU - de Lima Docema, Marcos F.
AU - Depretto, Catherine
AU - Dominelli, Valeria
AU - Forrai, Gábor
AU - Girometti, Rossano
AU - Harms, Steven E.
AU - Hilborne, Sarah
AU - Ienzi, Raffaele
AU - Lobbes, Marc B.I.
AU - Losio, Claudio
AU - Mann, Ritse M.
AU - Montemezzi, Stefania
AU - Obdeijn, Inge Marie
AU - Ozcan, Umit A.
AU - Pediconi, Federica
AU - Pinker, Katja
AU - Preibsch, Heike
AU - Raya Povedano, José L.
AU - Rossi Saccarelli, Carolina
AU - Sacchetto, Daniela
AU - Scaperrotta, Gianfranco P.
AU - Schlooz, Margrethe
AU - Szabó, Botond K.
AU - Taylor, Donna B.
AU - Ulus, Özden S.
AU - Van Goethem, Mireille
AU - Veltman, Jeroen
AU - Weigel, Stefanie
AU - Wenkel, Evelyn
AU - Zuiani, Chiara
AU - Sardanelli, Francesco
N1 - Funding Information:
Nehmat Houssami receives research funding via a National Breast Cancer Foundation (NBCF Australia) Breast Cancer Research Leadership Fellowship.
Funding Information:
Open access funding provided by Università degli Studi di Milano within the CRUI-CARE Agreement. This study received an unconditional research grant from Bayer AG. This company did not have any influence on the study protocol planning, did not have any access to the study database, and was not involved in any way in the manuscript writing or submission phases.
Funding Information:
Fiona J. Gilbert received research grants from General Electric Healthcare, GSK, and Hologic, and had research collaborations with Volpara and Bayer. She is an NIHR senior investigator and receives funding from the Cambridge BRC.
Funding Information:
Katja Pinker declares funding by the NIH/NCI Cancer Centre Support Grant P30 CA008748, Digital Hybrid Breast PET/MRI for Enhanced Diagnosis of Breast Cancer (HYPMED), H2020—Research and Innovation Framework Programme PHC-11-2015 # 667211-2, A Body Scan for Cancer Detection using Quantum Technology (CANCERSCAN), H2020-FETOPEN-2018-2019-2020-01 # 828978, Multiparametric 18F-Fluoroestradiol PET/MRI coupled with Radiomics Analysis and Machine Learning for Prediction and Assessment of Response to Neoadjuvant Endocrine Therapy in Patients with Hormone Receptor+/HER2− Invasive Breast Cancer 02.09.2019/31.08.2020 # Nr: 18207, Jubiläumsfonds of the Austrian National Bank.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/9
Y1 - 2023/9
N2 - Objectives: To report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/nonreferral and other covariates in driving surgical outcomes. Methods: The MIPA observational study enrolled women aged 18–80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis. Results: A total of 5828 patients entered analysis, 2763 (47.4%) did not undergo MRI (noMRI subgroup) and 3065 underwent MRI (52.6%); of the latter, 2441/3065 (79.7%) underwent MRI with preoperative intent (P-MRI subgroup), 510/3065 (16.6%) D-MRI, and 114/3065 S-MRI (3.7%). The reoperation rate was 10.5% for S-MRI, 8.2% for D-MRI, and 8.5% for P-MRI, while it was 11.7% for noMRI (p ≤ 0.023 for comparisons with D-MRI and P-MRI). The overall mastectomy rate (first-line mastectomy plus conversions from conserving surgery to mastectomy) was 39.5% for S-MRI, 36.2% for P-MRI, 24.1% for D-MRI, and 18.0% for noMRI. At multivariable analysis, using noMRI as reference, the odds ratios for overall mastectomy were 2.4 (p < 0.001) for S-MRI, 1.0 (p = 0.957) for D-MRI, and 1.9 (p < 0.001) for P-MRI. Conclusions: Patients from the D-MRI subgroup had the lowest overall mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). This analysis offers an insight into how the initial indication for MRI affects the subsequent surgical treatment of breast cancer. Key Points: • Of 3065 breast MRI examinations, 79.7% were performed with preoperative intent (P-MRI), 16.6% were diagnostic (D-MRI), and 3.7% were screening (S-MRI) examinations. • The D-MRI subgroup had the lowest mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). • The S-MRI subgroup had the highest mastectomy rate (39.5%) which aligns with higher-than-average risk in this subgroup, with a reoperation rate (10.5%) not significantly different to that of all other subgroups.
AB - Objectives: To report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/nonreferral and other covariates in driving surgical outcomes. Methods: The MIPA observational study enrolled women aged 18–80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis. Results: A total of 5828 patients entered analysis, 2763 (47.4%) did not undergo MRI (noMRI subgroup) and 3065 underwent MRI (52.6%); of the latter, 2441/3065 (79.7%) underwent MRI with preoperative intent (P-MRI subgroup), 510/3065 (16.6%) D-MRI, and 114/3065 S-MRI (3.7%). The reoperation rate was 10.5% for S-MRI, 8.2% for D-MRI, and 8.5% for P-MRI, while it was 11.7% for noMRI (p ≤ 0.023 for comparisons with D-MRI and P-MRI). The overall mastectomy rate (first-line mastectomy plus conversions from conserving surgery to mastectomy) was 39.5% for S-MRI, 36.2% for P-MRI, 24.1% for D-MRI, and 18.0% for noMRI. At multivariable analysis, using noMRI as reference, the odds ratios for overall mastectomy were 2.4 (p < 0.001) for S-MRI, 1.0 (p = 0.957) for D-MRI, and 1.9 (p < 0.001) for P-MRI. Conclusions: Patients from the D-MRI subgroup had the lowest overall mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). This analysis offers an insight into how the initial indication for MRI affects the subsequent surgical treatment of breast cancer. Key Points: • Of 3065 breast MRI examinations, 79.7% were performed with preoperative intent (P-MRI), 16.6% were diagnostic (D-MRI), and 3.7% were screening (S-MRI) examinations. • The D-MRI subgroup had the lowest mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). • The S-MRI subgroup had the highest mastectomy rate (39.5%) which aligns with higher-than-average risk in this subgroup, with a reoperation rate (10.5%) not significantly different to that of all other subgroups.
KW - Breast neoplasms
KW - Breast-conserving surgery
KW - Magnetic resonance imaging
KW - Mastectomy
KW - Reoperation
UR - http://www.scopus.com/inward/record.url?scp=85158138407&partnerID=8YFLogxK
U2 - 10.1007/s00330-023-09600-5
DO - 10.1007/s00330-023-09600-5
M3 - Article
C2 - 37138190
AN - SCOPUS:85158138407
SN - 0938-7994
VL - 33
SP - 6213
EP - 6225
JO - European radiology
JF - European radiology
IS - 9
ER -
