ObjectivesTo report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/nonreferral and other covariates in driving surgical outcomes.MethodsThe MIPA observational study enrolled women aged 18-80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis.ResultsA total of 5828 patients entered analysis, 2763 (47.4%) did not undergo MRI (noMRI subgroup) and 3065 underwent MRI (52.6%); of the latter, 2441/3065 (79.7%) underwent MRI with preoperative intent (P-MRI subgroup), 510/3065 (16.6%) D-MRI, and 114/3065 S-MRI (3.7%). The reoperation rate was 10.5% for S-MRI, 8.2% for D-MRI, and 8.5% for P-MRI, while it was 11.7% for noMRI (p <= 0.023 for comparisons with D-MRI and P-MRI). The overall mastectomy rate (first-line mastectomy plus conversions from conserving surgery to mastectomy) was 39.5% for S-MRI, 36.2% for P-MRI, 24.1% for D-MRI, and 18.0% for noMRI. At multivariable analysis, using noMRI as reference, the odds ratios for overall mastectomy were 2.4 (p < 0.001) for S-MRI, 1.0 (p = 0.957) for D-MRI, and 1.9 (p < 0.001) for P-MRI.ConclusionsPatients from the D-MRI subgroup had the lowest overall mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). This analysis offers an insight into how the initial indication for MRI affects the subsequent surgical treatment of breast cancer.
Screening and diagnostic breast MRI: how do they impact surgical treatment? Insights from the MIPA study / Cozzi, Andrea; Di Leo, Giovanni; Houssami, Nehmat; Gilbert, Fiona J; Helbich, Thomas H; Álvarez Benito, Marina; Balleyguier, Corinne; Bazzocchi, Massimo; Bult, Peter; Calabrese, Massimo; Camps Herrero, Julia; Cartia, Francesco; Cassano, Enrico; Clauser, Paola; de Lima Docema, Marcos F; Depretto, Catherine; Dominelli, Valeria; Forrai, Gábor; Girometti, Rossano; Harms, Steven E; Hilborne, Sarah; Ienzi, Raffaele; Lobbes, Marc B I; Losio, Claudio; Mann, Ritse M; Montemezzi, Stefania; Obdeijn, Inge-Marie; Ozcan, Umit A; Pediconi, Federica; Pinker, Katja; Preibsch, Heike; Raya Povedano, José L; Rossi Saccarelli, Carolina; Sacchetto, Daniela; Scaperrotta, Gianfranco P; Schlooz, Margrethe; Szabó, Botond K; Taylor, Donna B; Ulus, Özden S; Van Goethem, Mireille; Veltman, Jeroen; Weigel, Stefanie; Wenkel, Evelyn; Zuiani, Chiara; Sardanelli, Francesco. - In: EUROPEAN RADIOLOGY. - ISSN 0938-7994. - 33:9(2023), pp. 6213-6225. [10.1007/s00330-023-09600-5]
Screening and diagnostic breast MRI: how do they impact surgical treatment? Insights from the MIPA study
Di Leo, GiovanniSecondo
;Dominelli, Valeria;Pediconi, Federica;Sardanelli, Francesco
Ultimo
2023
Abstract
ObjectivesTo report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/nonreferral and other covariates in driving surgical outcomes.MethodsThe MIPA observational study enrolled women aged 18-80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis.ResultsA total of 5828 patients entered analysis, 2763 (47.4%) did not undergo MRI (noMRI subgroup) and 3065 underwent MRI (52.6%); of the latter, 2441/3065 (79.7%) underwent MRI with preoperative intent (P-MRI subgroup), 510/3065 (16.6%) D-MRI, and 114/3065 S-MRI (3.7%). The reoperation rate was 10.5% for S-MRI, 8.2% for D-MRI, and 8.5% for P-MRI, while it was 11.7% for noMRI (p <= 0.023 for comparisons with D-MRI and P-MRI). The overall mastectomy rate (first-line mastectomy plus conversions from conserving surgery to mastectomy) was 39.5% for S-MRI, 36.2% for P-MRI, 24.1% for D-MRI, and 18.0% for noMRI. At multivariable analysis, using noMRI as reference, the odds ratios for overall mastectomy were 2.4 (p < 0.001) for S-MRI, 1.0 (p = 0.957) for D-MRI, and 1.9 (p < 0.001) for P-MRI.ConclusionsPatients from the D-MRI subgroup had the lowest overall mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). This analysis offers an insight into how the initial indication for MRI affects the subsequent surgical treatment of breast cancer.| File | Dimensione | Formato | |
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