Please use this identifier to cite or link to this item: http://hdl.handle.net/1946/6990
The impact of preoperative breast MRI on surgical planning in women with incident breast cancer
Introduction: Routine breast Magnetic Resonance Imaging (MRI) has recently been introduced in Iceland as a preoperative examination of patients with incident breast cancer. Previous studies report that additional lesions not detected on mammography can be identified with MRI, which may result in revised surgical planning.
Objectives: The aim of this study is to determine if additional findings on preoperative breast MRI changed the planned surgical treatment.
Methods: This is a descriptive case series of 284 female patients who underwent breast MRI in the years 2007 and 2008 at Landspitali-University Hospital, Reykjavík, Iceland. The results of mammography and breast MRI were compared for each patient. If an additional lesion was detected on breast MRI, a breast surgeon evaluated if the planning of the surgical treatment was altered.
Results: An additional lesion was detected on breast MRI in 43 women (15.1%). In 23 women (8.1%) the additional lesion was found in the ipsilateral breast and in 17 (6%) in the contralateral breast. In three women (1%) the breast MRI showed bilateral lesions that were not detected on mammography. Due to the MRI findings surgical planning was changed in 20 women (7%). A wider unilateral excision was performed in nine women (3.2%) and in 11 cases (3.9%) bilateral surgery was performed instead of unilateral.
Conclusion: The results of this study confirm previous reports that preoperative breast MRI detects additional lesions, benign and malignant, in a substantial number of breast cancer patients and can alter the surgical treatment in approximately half of these patients.