Fabio Chiesa, Presenter: Nothing to Disclose

Alessandro Villa, Abstract Co-Author: Nothing to Disclose

Massimo Calabrese MD, Abstract Co-Author: Nothing to Disclose

Daniele Friedman, Abstract Co-Author: Nothing to Disclose

Luca Alessandro Carbonaro MD, Abstract Co-Author: Nothing to Disclose

Francesco Sardanelli MD, Abstract Co-Author: Consultant, Bracco Group

Our aim was to review the electronic database of our institution and verify whether the constantly raising use of breast magnetic resonance imaging (MRI) for preoperative staging of breast cancer was associated with an increasing mastectomy rate.

Electronic database of our academic Breast Surgery Unit was accessed. Chi square and Spearman correlation were used.

From January 2003 to December 2008, 1,522 breast surgical procedures were performed. The clinical indication for 983 interventions was the removal of a needle-biopsy proven malignancy. Of 983 patients, 168 underwent mastectomy for extensive disease diagnosed with imaging modalities or during surgical intervention. Preoperative staging MRI was performed in 105 patients. The mastectomy rate for the total number of performed surgical treatments was 25/121 (20.7%) in 2003, 25/159 (15.7%) in 2004, 22/140 (15.7%) in 2005, 21/161 (13%) in 2006, 26/182 (14.3%) in 2007, and 49/220 (21.4%) in 2008. The preoperative MRI examinations were 3 in 2003, 2 in 2004, 13 in 2005, 14 in 2006, 31 in 2007, and 42 in 2008. The overall rate of mastectomies for the 5-years period was 168/983 (17.1%), with a stratified mastectomy rate of 37.1% for the patients who underwent preoperative MRI and 14.6% for the patients staged without MRI (P < 0.01). No significant correlation was found between mastectomy rate and number of preoperative MRI examinations performed in the 5-year period (r = 0.21).

We have increasingly performed MRI to improve the surgical planning of breast cancer patients with no significant increase in the total mastectomy rate, this rate remaining under 22% during the whole period. The higher mastectomy rate in patients who performed preoperative MRI can be easily explained by the preferred use of preoperative MRI in patients with a higher suspicion of extensive disease at clinical examination and conventional imaging (mammography and sonography).

Preoperative MRI can be implemented in clinical practice without increasing the mastectomy rate.

Chiesa, F, Villa, A, Calabrese, M, Friedman, D, Carbonaro, L, Sardanelli, F, Preoperative Breast MRI and Mastectomy Rate: A 5 Year Single Center Experience.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9014153.html