Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA)

Sardanelli F, Trimboli RM, Houssami N, Gilbert FJ, Helbich TH, Alvarez Benito M, Balleyguier C, Bazzocchi M, Bult P, Calabrese M, Camps Herrero J, Cartia F, Cassano E, Clauser P, Cozzi A, De Andrade DA, De Lima Docema MF, Depretto C, Dominelli V, Forrai G, Girometti R, Harms SE, Hilborne S, Ienzi R, Lobbes MB, Losio C, Mann RM, Montemezzi S, Obdeijn IM, Ozcan UA, Pediconi F, Pinker K, Preibsch H, Raya Povedano JL, Sacchetto D, Scaperrotta GP, Schiaffino S, Schlooz M, Szabo BK, Taylor DB, Ulus OS, Van Goethem M, Veltman J, Weigel S, Wenkel E, Zuiani C, Di Leo G (2021)

Publication Type: Journal article

Publication year: 2021

Journal

DOI: 10.1007/s00330-021-08240-x

Abstract

Objectives Preoperative breast magnetic resonance imaging (MRI) can inform surgical planning but might cause overtreatment by increasing the mastectomy rate. The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue. Methods This observational study enrolled women aged 18-80 years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers. Exclusion criteria included planned neoadjuvant therapy, pregnancy, personal history of any cancer, and distant metastases. Results Of 5896 analyzed patients, 2763 (46.9%) had conventional imaging only (noMRI group), and 3133 (53.1%) underwent MRI that was performed for diagnosis, screening, or unknown purposes in 692/3133 women (22.1%), with preoperative intent in 2441/3133 women (77.9%, MRI group). Patients in the MRI group were younger, had denser breasts, more cancers >= 20 mm, and a higher rate of invasive lobular histology than patients who underwent conventional imaging alone (p < 0.001 for all comparisons). Mastectomy was planned based on conventional imaging in 22.4% (MRI group) versus 14.4% (noMRI group) (p < 0.001). The additional planned mastectomy rate in the MRI group was 11.3%. The overall performed first- plus second-line mastectomy rate was 36.3% (MRI group) versus 18.0% (noMRI group) (p < 0.001). In women receiving conserving surgery, MRI group had a significantly lower reoperation rate (8.5% versus 11.7%, p < 0.001). Conclusions Clinicians requested breast MRI for women with a higher a priori probability of receiving mastectomy. MRI was associated with 11.3% more mastectomies, and with 3.2% fewer reoperations in the breast conservation subgroup.

Authors with CRIS profile

Involved external institutions

Università degli studi di Milano Italy (IT) University of Sydney (USYD) Australia (AU) University of Cambridge United Kingdom (GB) Medizinische Universität Wien Austria (AT) Hospital Universitario Reina Sofía de Córdoba Edificio IMIBIC Spain (ES) Institut Gustave-Roussy France (FR) University of Udine / Università degli Studi di Udine Italy (IT) Radboud University Nijmegen Netherlands (NL) Ospedale San Martino (IRCCS AOU) Italy (IT) University Hospital of La Ribera / Hospital Universitario de La Ribera Spain (ES) Fondazione IRCCS: Istituto Nazionale dei Tumori Italy (IT) European Institute of Oncology / Istituto Europeo di Oncologia (IEO) Italy (IT) Hospital Sírio-Libanês Brazil (BR) Semmelweis University / Semmelweis Egyetem Hungary (HU) Breast Center A MANA Clinic United States (USA) (US) Università degli Studi di Palermo Italy (IT) Maastricht University Netherlands (NL) Ospedale San Raffaele (früher: Centro San Raffaele del Monte Tabor Foundation) Italy (IT) University Hospital of Verona / Azienda Ospedaliera Universitaria Integrata Verona (AOUI) Italy (IT) Erasmus University Medical Center (MC) Netherlands (NL) Acıbadem Üniversitesi Turkey (TR) Università degli studi "La Sapienza" Italy (IT) Universitätsklinikum Tübingen Germany (DE) Kiwifarm Srl Italy (IT) IRCCS Policlinico San Donato Italy (IT) Barking, Havering and Redbridge University Hospitals NHS Trust United Kingdom (GB) University of Western Australia (UWA) Australia (AU) University of Antwerp / Universiteit Antwerpen Belgium (BE) Maatschap Radiol Oost Nederland (MRON) Netherlands (NL) Westfälische Wilhelms-Universität (WWU) Münster Germany (DE)

How to cite

APA:

Sardanelli, F., Trimboli, R.M., Houssami, N., Gilbert, F.J., Helbich, T.H., Alvarez Benito, M.,... Di Leo, G. (2021). Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA). European Radiology. https://doi.org/10.1007/s00330-021-08240-x

MLA:

Sardanelli, Francesco, et al. "Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA)." European Radiology (2021).

BibTeX: Download