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Magnetic resonance imaging in the planning of initial lumpectomy for invasive breast carcinoma: its effect on ipsilateral breast tumor recurrence after breast-conservation therapy
Annals of Surgical Oncology, 07/20/09

Hwang N et al. - In a trial to determine whether magnetic resonance imaging (MRI) in the planning of the first lumpectomy reduces ipsilateral breast tumor recurrence (IBTR), it was shown that MRI evaluation of invasive carcinoma in the planning of initial lumpectomies was not associated with improved local outcomes after breast-conserving surgery (BCS) with radiation (RT), it was reported that MRI evaluation of invasive carcinoma in the planning of initial lumpectomies was not associated with improved local outcomes after BCS with RT.

Methods

Using a prospective database, 472 initial lumpectomies from 463 women between 1999 and 2005 were examined.
All pts had invasive cancer excised to negative margins on BCS, received RT, and were followed.
IBTR rates were calculated by Kaplan–Meier method.
Univariate and multivariate analyses were performed to investigate the association between MRI for initial lumpectomies and IBTR outcomes.

Results

MRI was performed before 127 (27%) lumpectomies, while 345 (73%) pts did not have a preoperative breast MRI.
At median follow-up of 54 mos, there was no significant difference in actuarial 8-yr IBTR rates between women with preoperative MRI evaluation and women without MRI (1.8% vs 2.5%, respectively).
After adjusting for adjuvant therapies, pt, and tumor characteristics, there continued to be no increased risk of IBTR.
MRI visualization of tumors prior to lumpectomy did not influence achievement of negative margins and was not associated with lower rates of re-excision (MRI: 11.8% vs no-MRI: 13.3%).

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