Screening and diagnostic breast MRI: how do they impact surgical treatment? Insights from the MIPA study

ObjectivesTo 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.MethodsThe MI...

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Detalhes bibliográficos
Autores: Cozzi, A, Di Leo, G, Houssami, N, Gilbert, FJ, Helbich, TH, Benito, MA, Balleyguier, C, Bazzocchi, M, Bult, P, Calabrese, M, Herrero, JC, Cartia, F, Cassano, E, Clauser, P, Docema, MD, Depretto, C, Dominelli, V, Forrai, G, Girometti, R, Harms, SE, Hilborne, S, Ienzi, R, Lobbes, MBI, Losio, C, Mann, RM, Montemezzi, S, Obdeijn, IM, Ozcan, UA, Pediconi, F, Pinker, K, Preibsch, H, Povedano, JLR, Saccarelli, CR, Sacchetto, D, Scaperrotta, GP, Schlooz, M, Szabo, BK, Taylor, DB, Ulus, S, Van Goethem, M, Veltman, J, Weigel, S, Wenkel, E, Zuiani, C, Sardanelli, F
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Recursos:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p15319
Acesso em linha:https://fisabio.portalinvestigacion.com/publicaciones/15319
Access Level:acceso abierto
Palavra-chave:Breast-conserving surgery
Breast neoplasms
Magnetic resonance imaging
Mastectomy
Reoperation
Descrição
Resumo:ObjectivesTo 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.MethodsThe 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.ResultsA 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.ConclusionsPatients 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.

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