MRI offers little benefit for women undergoing surgery for early breast cancer

MRI right before or after surgery in women with ductal carcinoma in situ (DCIS) was not associated with reduced recurrence or contralateral breast cancer rates, according to a study presented Sept. 7 at the 2013 Breast Cancer Symposium.

The findings echo previous studies which have found MRI around the time of surgery for invasive breast cancer does not have a clinically significant impact on local recurrence or contralateral breast cancer rates.

“MRI is an expensive test with a high false-positive rate that can lead to additional and sometimes unnecessary procedures, so its use should be examined carefully,” Melissa L. Pilewskie, MD, breast surgeon at Memorial Sloan-Kettering Cancer Center in New York City, said in a press release. “These findings add to the growing list of evidence that suggests that MRI does not provide a clear benefit for DCIS patients.”

Since the impact of MRI on women with DCIS—ordered either before surgery to clearly image the cancer or to check for residual disease after surgery—was not as well studied as the impact MRI had on invasive cancer, Pilewskie and colleagues looked at the cases of women who had breast-conserving surgery for DCIS between 1997 and 2010 at Memorial Sloan-Kettering. Of the 2,321 women who had surgery during this period, 596 received an MRI either before or immediately after surgery.

After five years, results showed local recurrence rates were 8.5 percent with MRI compared with 7.2 percent without MRI, a difference that was not statistically significant, reported Pilewskie and colleagues. Eight-year recurrence rates also were not significantly different, even after controlling for nine patient variables such as age and menopausal status.

Not all women with DCIS receive radiation therapy after surgery to reduce recurrence, but even among women who did not receive radiation therapy, MRI was not associated with improved long-term outcomes, according to the researchers.

The study also found no statistically significant difference in contralateral breast cancer rates with the use of MRI.