Meta-analysis of pre-operative magnetic resonance imaging (MRI) and surgical treatment for breast cancer Journal Article


Authors: Houssami, N.; Turner, R. M.; Morrow, M.
Article Title: Meta-analysis of pre-operative magnetic resonance imaging (MRI) and surgical treatment for breast cancer
Abstract: Background: Although there is no consensus on whether pre-operative MRI in women with breast cancer (BC) benefits surgical treatment, MRI continues to be used pre-operatively in practice. This meta-analysis examines the association between pre-operative MRI and surgical outcomes in BC. Methods: A systematic review was performed to identify studies reporting quantitative data on pre-operative MRI and surgical outcomes (without restriction by type of surgery received or type of BC) and using a controlled design. Random-effects logistic regression calculated the pooled odds ratio (OR) for each surgical outcome (MRI vs. no-MRI groups), and estimated ORs stratified by study-level age. Subgroup analysis was performed for invasive lobular cancer (ILC). Results: Nineteen studies met eligibility criteria: 3 RCTs and 16 comparative studies that included newly diagnosed BC of any type except for three studies restricted to ILC. Primary analysis (85,975 subjects) showed that pre-operative MRI was associated with increased odds of receiving mastectomy [OR 1.39 (1.23, 1.57); p < 0.001]; similar findings were shown in analyses stratified by study-level median age. Secondary analyses did not find statistical evidence of an effect of MRI on the rates of re-excision, re-operation, or positive margins; however, MRI was significantly associated with increased odds of receiving contralateral prophylactic mastectomy [OR 1.91 (1.25, 2.91); p = 0.003]. Subgroup analysis for ILC did not find any association between MRI and the odds of receiving mastectomy [OR 1.00 (0.75, 1.33); p = 0.988] or the odds of re-excision [OR 0.65 (0.35, 1.24); p = 0.192]. Conclusions: Pre-operative MRI is associated with increased odds of receiving ipsilateral mastectomy and contralateral prophylactic mastectomy as surgical treatment in newly diagnosed BC patients. © 2017, Springer Science+Business Media New York.
Keywords: magnetic resonance imaging; breast cancer; mastectomy; meta-analysis; breast-conserving surgery; re-operation
Journal Title: Breast Cancer Research and Treatment
Volume: 165
Issue: 2
ISSN: 0167-6806
Publisher: Springer  
Date Published: 2017-09-01
Start Page: 273
End Page: 283
Language: English
DOI: 10.1007/s10549-017-4324-3
PROVIDER: scopus
PMCID: PMC5580248
PUBMED: 28589366
DOI/URL:
Notes: Review -- Export Date: 1 September 2017 -- Source: Scopus
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  1. Monica Morrow
    772 Morrow