Does Preoperative MRI Reduce Positive Margins after Breast-Conserving Surgery?

Area of Science:

• Oncology
• Radiology
• Surgical Oncology

Background:

• Breast-conserving surgery (BCS) is a standard treatment for breast cancer, with negative margins being crucial for successful outcomes.
• Preoperative magnetic resonance imaging (MRI) has been proposed as a tool to improve margin status in BCS.
• This study investigated the association between preoperative MRI and positive margins in BCS.

Purpose of the Study:

• To determine if preoperative MRI use is associated with a reduction in positive margins after breast-conserving surgery.
• To identify factors influencing margin status in patients undergoing BCS.

Main Methods:

• Analysis of data from the multicenter SHAVE/SHAVE2 trials involving patients with stage 0-3 breast cancer undergoing BCS.
• Evaluation of margin status in relation to the use of preoperative MRI, with MRI use at the surgeon's discretion.
• Multivariate analysis controlling for patient and tumor characteristics to assess the impact of preoperative MRI on margin status.

Main Results:

• A total of 631 patients were included; 30.6% underwent preoperative MRI.
• Patients with preoperative MRI showed a trend towards fewer positive margins (31.1% vs. 38.8%), but this was not statistically significant (p=0.073).
• Multivariate analysis indicated that preoperative MRI was not a significant predictor of margin status; only patient age and tumor size were significant factors (p=0.032 and p=0.040, respectively).

Conclusions:

• Preoperative MRI is not significantly associated with improved margin status in breast-conserving surgery.
• Patient age and tumor size are the primary factors associated with margin status in BCS.
• Further research may be needed to clarify the role of MRI in specific patient subgroups or surgical techniques.