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Preoperative MRI in breast cancer patients can detect new disease, particularly in those with positive lymph nodes. This finding may alter surgical management, especially for node-positive cases.

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Area of Science:

  • Oncology
  • Radiology
  • Breast Cancer Imaging

Background:

  • Preoperative magnetic resonance imaging (MRI) is utilized in breast cancer management.
  • Identifying predictive factors for the benefit of preoperative MRI is crucial for optimizing patient care.

Purpose of the Study:

  • To determine factors that predict the benefit of preoperative MRI in breast cancer patients.
  • To assess the impact of preoperative MRI on surgical management.

Main Methods:

  • Retrospective review of breast cancer patients who underwent preoperative MRI between 2018-2021.
  • Patients were categorized into groups based on whether new disease was detected on MRI.

Main Results:

  • 17% of patients showed new multicentric, multifocal, or contralateral disease on preoperative MRI.
  • Positive lymph nodes on ultrasound or mammogram were significantly associated with the detection of new or multifocal disease on MRI (p=0.0005).
  • Preoperative MRI led to more extensive surgery in 22.2% of patients without new disease detected versus 6.9% in those with new disease detected (p<0.001).

Conclusions:

  • Nodal status is a key predictor for detecting additional multifocal, multicentric, or contralateral disease via preoperative MRI.
  • Preoperative MRI is particularly valuable in node-positive breast cancer patients for identifying disease extent that may alter surgical plans.