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

  1. Cozzi, Andrea
  2. Di Leo, Giovanni
  3. Houssami, Nehmat
  4. Gilbert, Fiona J.
  5. Helbich, Thomas H.
  6. Álvarez Benito, Marina
  7. Balleyguier, Corinne
  8. Bazzocchi, Massimo
  9. Bult, Peter
  10. Calabrese, Massimo
  11. Camps Herrero, Julia
  12. Cartia, Francesco
  13. Cassano, Enrico
  14. Clauser, Paola
  15. de Lima Docema, Marcos F.
  16. Depretto, Catherine
  17. Dominelli, Valeria
  18. Forrai, Gábor
  19. Girometti, Rossano
  20. Harms, Steven E.
  21. Hilborne, Sarah
  22. Ienzi, Raffaele
  23. Lobbes, Marc B. I.
  24. Losio, Claudio
  25. Mann, Ritse M.
  26. Montemezzi, Stefania
  27. Obdeijn, Inge-Marie
  28. Aksoy Ozcan, Umit
  29. Pediconi, Federica
  30. Pinker, Katja
  31. Preibsch, Heike
  32. Raya Povedano, José L.
  33. Rossi Saccarelli, Carolina
  34. Sacchetto, Daniela
  35. Scaperrotta, Gianfranco P.
  36. Schlooz, Margrethe
  37. Szabó, Botond K.
  38. Taylor, Donna B.
  39. Ulus, Sila Ö.
  40. Van Goethem, Mireille
  41. Veltman, Jeroen
  42. Weigel, Stefanie
  43. Wenkel, Evelyn
  44. Zuiani, Chiara
  45. Sardanelli, Francesco ORCID logo

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1000 Titel
  • Preoperative breast MRI positively impacts surgical outcomes of needle biopsy–diagnosed pure DCIS: a patient-matched analysis from the MIPA study
1000 Autor/in
  1. Cozzi, Andrea |
  2. Di Leo, Giovanni |
  3. Houssami, Nehmat |
  4. Gilbert, Fiona J. |
  5. Helbich, Thomas H. |
  6. Álvarez Benito, Marina |
  7. Balleyguier, Corinne |
  8. Bazzocchi, Massimo |
  9. Bult, Peter |
  10. Calabrese, Massimo |
  11. Camps Herrero, Julia |
  12. Cartia, Francesco |
  13. Cassano, Enrico |
  14. Clauser, Paola |
  15. de Lima Docema, Marcos F. |
  16. Depretto, Catherine |
  17. Dominelli, Valeria |
  18. Forrai, Gábor |
  19. Girometti, Rossano |
  20. Harms, Steven E. |
  21. Hilborne, Sarah |
  22. Ienzi, Raffaele |
  23. Lobbes, Marc B. I. |
  24. Losio, Claudio |
  25. Mann, Ritse M. |
  26. Montemezzi, Stefania |
  27. Obdeijn, Inge-Marie |
  28. Aksoy Ozcan, Umit |
  29. Pediconi, Federica |
  30. Pinker, Katja |
  31. Preibsch, Heike |
  32. Raya Povedano, José L. |
  33. Rossi Saccarelli, Carolina |
  34. Sacchetto, Daniela |
  35. Scaperrotta, Gianfranco P. |
  36. Schlooz, Margrethe |
  37. Szabó, Botond K. |
  38. Taylor, Donna B. |
  39. Ulus, Sila Ö. |
  40. Van Goethem, Mireille |
  41. Veltman, Jeroen |
  42. Weigel, Stefanie |
  43. Wenkel, Evelyn |
  44. Zuiani, Chiara |
  45. Sardanelli, Francesco |
1000 Verlag Springer Berlin Heidelberg
1000 Erscheinungsjahr 2023
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2023-11-24
1000 Erschienen in
1000 Quellenangabe
  • 34(6):3970-3980
1000 Copyrightjahr
  • 2023
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00330-023-10409-5 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11166778/ |
1000 Publikationsstatus
1000 Begutachtungsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • <jats:title>Abstract</jats:title><jats:sec> <jats:title>Objectives</jats:title> <jats:p>To investigate the influence of preoperative breast MRI on mastectomy and reoperation rates in patients with pure ductal carcinoma in situ (DCIS).</jats:p> </jats:sec><jats:sec> <jats:title>Methods</jats:title> <jats:p>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).</jats:p> </jats:sec><jats:sec> <jats:title>Results</jats:title> <jats:p>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, <jats:italic>p</jats:italic> = 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, <jats:italic>p</jats:italic> &lt; 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, <jats:italic>p</jats:italic> = 0.111).</jats:p> </jats:sec><jats:sec> <jats:title>Conclusions</jats:title> <jats:p>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.</jats:p> </jats:sec><jats:sec> <jats:title>Clinical relevance statement</jats:title> <jats:p>When confounding factors behind MRI referral are accounted for in the comparison of patients with CNB/VAB-diagnosed pure unilateral DCIS, preoperative MRI yields a reduction of reoperations that is more than twice as high as the increase in overall mastectomies.</jats:p> </jats:sec><jats:sec> <jats:title>Key Points</jats:title> <jats:p>• <jats:italic>Confounding factors cause imbalance when investigating the influence of preoperative MRI on surgical outcomes of pure DCIS.</jats:italic></jats:p> <jats:p>• <jats:italic>When patient matching is applied to women with pure unilateral DCIS, reoperation rates are significantly reduced in women who underwent preoperative MRI.</jats:italic></jats:p> <jats:p>• <jats:italic>The reduction of reoperations brought about by preoperative MRI is more than double the increase in overall mastectomies.</jats:italic></jats:p> </jats:sec>
1000 Sacherschließung
lokal Aged, 80 and over [MeSH]
lokal Aged [MeSH]
lokal Biopsy, Needle [MeSH]
lokal Carcinoma, Intraductal, Noninfiltrating/diagnostic imaging [MeSH]
lokal Preoperative Care/methods [MeSH]
lokal Breast
lokal Breast/diagnostic imaging [MeSH]
lokal Magnetic resonance imaging
lokal Carcinoma, Intraductal, Noninfiltrating/pathology [MeSH]
lokal Carcinoma, Intraductal, Noninfiltrating/surgery [MeSH]
lokal Breast Neoplasms/surgery [MeSH]
lokal Breast Neoplasms/pathology [MeSH]
lokal Reoperation/statistics
lokal Adolescent [MeSH]
lokal Breast Neoplasms/diagnostic imaging [MeSH]
lokal Female [MeSH]
lokal Adult [MeSH]
lokal Reoperation
lokal Humans [MeSH]
lokal Treatment Outcome [MeSH]
lokal Middle Aged [MeSH]
lokal Carcinoma (intraductal, noninfiltrating)
lokal Young Adult [MeSH]
lokal Breast neoplasms (biopsy, needle)
lokal Mastectomy/methods [MeSH]
lokal Magnetic Resonance Imaging/methods [MeSH]
lokal Mastectomy
lokal Breast/pathology [MeSH]
lokal Breast/surgery [MeSH]
1000 Fächerklassifikation (DDC)
1000 Liste der Beteiligten
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