Preoperative breast MRI positively impacts surgical outcomes of needle biopsy-diagnosed pure DCIS: a patient-matched analysis from the MIPA study

Objectives: To investigate the influence of preoperative breast MRI on mastectomy and reoperation rates in patients with pure ductal carcinoma in situ (DCIS).Methods: The MIPA observational study database (7245 patients) was searched for patients aged 18-80 years with pure unilateral DCIS diagnosed...

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Detalles 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, MFD, 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, SÖ, Van Goethem, M, Veltman, J, Weigel, S, Wenkel, E, Zuiani, C, Sardanelli, F
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución: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:p16406
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/16406
Access Level:acceso abierto
Palabra clave:Breast neoplasms (biopsy, needle)
Carcinoma (intraductal, noninfiltrating)
Magnetic resonance imaging
Mastectomy
Reoperation
Descripción
Sumario:Objectives: To investigate the influence of preoperative breast MRI on mastectomy and reoperation rates in patients with pure ductal carcinoma in situ (DCIS).Methods: The MIPA observational study database (7245 patients) was searched for patients aged 18-80 years with pure unilateral DCIS diagnosed at core needle or vacuum-assisted biopsy (CNB/VAB) and planned for primary surgery. Patients who underwent preoperative MRI (MRI group) were matched (1:1) to those who did not receive MRI (noMRI group) according to 8 confounding covariates that drive referral to MRI (age; hormonal status; familial risk; posterior-to-nipple diameter; BI-RADS category; lesion diameter; lesion presentation; surgical planning at conventional imaging). Surgical outcomes were compared between the matched groups with nonparametric statistics after calculating odds ratios (ORs).Results: Of 1005 women with pure unilateral DCIS at CNB/VAB (507 MRI group, 498 noMRI group), 309 remained in each group after matching. First-line mastectomy rate in the MRI group was 20.1% (62/309 patients, OR 2.03) compared to 11.0% in the noMRI group (34/309 patients, p = 0.003). The reoperation rate was 10.0% in the MRI group (31/309, OR for reoperation 0.40) and 22.0% in the noMRI group (68/309, p < 0.001), with a 2.53 OR of avoiding reoperation in the MRI group. The overall mastectomy rate was 23.3% in the MRI group (72/309, OR 1.40) and 17.8% in the noMRI group (55/309, p = 0.111).Conclusions: Compared to those going directly to surgery, patients with pure DCIS at CNB/VAB who underwent preoperative MRI had a higher OR for first-line mastectomy but a substantially lower OR for reoperation.

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