Growing use of MRIs leading to more invasive breast cancer surgery

Heavy use of magnetic resonance imaging (MRI) may be leading to unnecessary breast removal in older women with breast cancer, according to a study by Yale School of Medicine researchers in the current issue of Breast Cancer Research and Treatment.

"These data are concerning because the long-term benefits associated with bilateral mastectomy for older women with are unclear," said the study's lead author Cary Gross. M.D., associate professor of internal medicine at Yale School of Medicine and director of the Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center at Yale Cancer Center.

"Patient concern about recurrence and survival must be balanced with the increased risk for complications associated with more surgery, particularly when there is no proven benefit of the more aggressive option," Gross added.

The research team tracked the use of breast MRI and surgical care of 72,461 female Medicare beneficiaries age 67-94 who were diagnosed with breast cancer during 2000 to 2009.

The team found a considerable increase in the use of preoperative breast MRI over the study period from 1% in 2000-2001 to 25% in 2008-2009. The researchers also found that women who received an MRI were more likely to subsequently undergo more aggressive surgical treatment. In women who received mastectomy, 12.5% of those who had MRI received bilateral mastectomy, while only 4.1% of those who did not have MRI had bilateral mastectomy.

The study also revealed that women undergoing MRI were more likely to have a contralateral prophylactic mastectomy (surgery to remove both breasts when cancer was only found in one breast). Among women who underwent mastectomy, 6.9% of women who had an MRI underwent contralateral prophylactic mastectomy, compared to 1.8% in women who did not have an MRI.

"There has been no randomized controlled clinical trial demonstrating improved outcomes for women who undergo preoperative breast MRI at any age," said Brigid Killelea, M.D., assistant professor of surgery at Yale School of Medicine, and first author on the study. "Breast conserving therapy, when feasible, remains the preferred approach for women with early stage breast cancer."

More information: Breast Cancer Research and Treatment, Published Online August 14, 2013. DOI: 10.1007/s10549-013-2656-1

Related Stories

Young breast cancer patients often opt for mastectomy

May 30, 2013

A new study of young women with breast cancer has found that most chose to have a mastectomy rather than a surgical procedure that would conserve the breast, researchers will report at the 49th Annual Meeting of the American ...

Recommended for you

Understanding your kidney tumor in 3D

29 minutes ago

Most patients rely on their doctors to decipher the black, white and gray images on their CT scans. But what if a patient could instead hold a 3D model made from the CT image in his hands? Suddenly, the picture ...

Biomarker in aggressive breast cancer identified

14 hours ago

Two Northwestern University scientists have identified a biomarker strongly associated with basal-like breast cancer, a highly aggressive carcinoma that is resistant to many types of chemotherapy. The biomarker, ...

MRI better detects recurrent breast cancer

15 hours ago

(HealthDay)—Single-screening breast magnetic resonance imaging (MRI) detects 18.1 additional cancers after negative findings with mammography and ultrasonography (US) per 1,000 women with a history of breast ...

Natural (born) killer cells battle pediatric leukemia

Aug 19, 2014

Researchers at Children's Hospital Los Angeles have shown that a select team of immune-system cells from patients with leukemia can be multiplied in the lab, creating an army of natural killer cells that ...

User comments