Christopher E. Comstock MD, Presenter: Speaker, Suros Surgical Systems, Inc Speakers Bureau, Johnson & Johnson (Endo-Surgery Institute)

Patrick Thomas Hunt MD, MBA, Abstract Co-Author: Nothing to Disclose

Michael Simca Middleton PhD, MD, Abstract Co-Author: Research Consultant, Siemens AG, Erlangen, Germany Research Consultant, Confirma, Inc, Bellevue, WA Grant, General Electric Company Stockholder, General Electric Company Grant, Bayer AG (Berlex Inc), Montville, NJ

To evaluate our mastectomy rate in relationship to utilization of pre-operative MRI. To evaluate the effect of pre-operative MRI on lumpectomy negative margin rates and time to surgery in women with know breast cancer.

A retrospective review was performed of patients with a core biopsy proven breast cancer who underwent surgery at our center from 2000 through 2006. A total of 481 patients were identified. The patient’s surgical outcomes and pathology results were recorded and radiology records were examined to identify patients that underwent pre-operative MRI. The standard breast DCE MRI protocol was: Siemens Symphony 1.5T, bilateral, fat saturation, axial, 348 x 512 matrix, 1.6 mm slice thickness, 88 slices, 5 post-contrast one minute sequences were obtained.

Despite the increasing utilization of pre-operative MRI in women with known breast cancer, our mastectomy rate remained stable from 2000 through 2006. The lumpectomy negative margin rate among women who underwent pre-operative MRI was higher (80%, 86/107) than that of women who did not undergo pre-operative MRI (75%, 172/229). The delay in time to surgery in patients who under went pre-operative MRI was not clinically significant.

If utilized correctly, high-quality pre-operative MRI can improve surgical outcomes in women with know breast cancer and planning lumpectomy without increasing the overall mastectomy rates.

The use of pre-operative MRI in women with breast cancer is variable in the United States due to the lack of data to support its use. Further studies are needed to evaluate its use.

Comstock, C, Hunt, P, Middleton, M, Effect of Preoperative MRI on Mastectomy Rates, Lumpectomy Negative Margin Rates, and Time to Surgery in Women with Known Breast Cancer.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005306.html