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Preoperative Breast MRI in Women 35 Years of Age and Younger with Breast Cancer: Benefits in Surgical Outcomes by Using Propensity Score Analysis

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Abstract
Background: The role of preoperative MRI in women 35 years of age or younger with breast cancer remains controversial.

Purpose: To determine the association between preoperative MRI and surgical outcomes in women aged 35 years or younger with breast cancer by using propensity score (PS) analysis to investigate the impact of preoperative MRI.

Materials and Methods: Women 35 years of age or younger diagnosed with breast cancer between 2007 and 2017 who had or had not undergone preoperative breast MRI were retrospectively identified. The MRI detection rate of additional suspicious lesions was analyzed, and changes in surgical management were recorded. Inverse probability weighting (IPW) and PS matching were used to adjust 19 variables and to create a balance between the two groups. Surgical outcomes were compared by using univariable logistic regression.

Results: Among 964 women (mean age +/- standard deviation, 32 years +/- 3), 665 (69%) had undergone preoperative MRI (MRI group; mean age, 32 years +/- 3) and 299 (31%) had not (no-MRI group; mean age, 32 years +/- 3). In the MRI group, additional suspicious lesions were found in 178 of the 665 women (27%), with 88 of those 178 women (49%) having malignant lesions. The surgical management was changed in 99 of the 665 women (15%) due to MRI findings, which was appropriate for 62 of those 99 women (63%). In the IPW analysis, the MRI group showed lower odds of repeat surgery (odds ratio [OR], 0.13; 95% CI: 0.07, 0.21; P < .001) and higher odds of initial mastectomy (OR, 1.62; 95% CI: 1.17, 2.25; P = .004). However, there was no difference in the overall mastectomy rate (OR, 1.24; 95% CI: 0.91, 1.68; P = .17) compared with the no-MRI group. These results were consistent when using the PS matching method.

Conclusion: Preoperative MRI in young women with breast cancer is useful for detecting additional malignancy and improving surgical outcomes by reducing the repeat surgery rate, with a similar likelihood of overall mastectomy. (C) RSNA, 2021
Author(s)
김학희박아름신희정차주희채은영최우정
Issued Date
2021
Type
Article
Keyword
AdolescentAdultBreast / diagnostic imagingBreast / surgeryBreast Neoplasms / diagnostic imaging*Breast Neoplasms / surgery*FemaleHumansMagnetic Resonance Imaging / methods*Mastectomy / methods*Preoperative Care / methods*Propensity ScoreRetrospective StudiesTreatment OutcomeYoung Adult
DOI
10.1148/radiol.2021204124
URI
https://oak.ulsan.ac.kr/handle/2021.oak/7397
https://ulsan-primo.hosted.exlibrisgroup.com/primo-explore/fulldisplay?docid=TN_cdi_crossref_primary_10_1148_radiol_2021204124&amp;context=PC&amp;vid=ULSAN&amp;lang=ko_KR&amp;search_scope=default_scope&amp;adaptor=primo_central_multiple_fe&amp;tab=default_tab&amp;query=any,contains,Preoperative%20Breast%20MRI%20in%20Women%2035%20Years%20of%20Age%20and%20Younger%20with%20Breast%20Cancer:%20Benefits%20in%20Surgical%20Outcomes%20by%20Using%20Propensity%20Score%20Analysis&amp;offset=0&amp;pcAvailability=true
Publisher
RADIOLOGY
Location
미국
Language
영어
ISSN
0033-8419
Citation Volume
300
Citation Number
1
Citation Start Page
39
Citation End Page
45
Appears in Collections:
Medicine > Medicine
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