The impact of preoperative breast MRI on the surgical management of newly diagnosed non metastatic breast cancers

Background: Preoperative MRI (magnetic resonance imaging) of the breast is likely to accurately stage the disease and thereby influence the surgical decision making in newly diagnosed non metastatic breast cancers. We assessed the impact of preoperative contrast-enhanced MRI in surgical management of women with early breast cancer. Design: Prospective retrospective study of 48 cases of newly detected non metastatic breast cancers in an Oncology unit of a tertiary care teaching hospital. Enrolled patients were assessed with preoperative MRI of breasts and findings were compared with standard sonomammography findings. Appropriate stage wise treatment plan was devised in conjunction with MRI findings and were corroborated with histopathological examination results. Outcomes: Primary outcome was assessment of changes in the surgical management of newly detected non metastatic breast cancer as a result of findings revealed in the preoperative MRI of breasts. The agreement of assessment between new MRI findings vis-à-vis histopathology of new lesion was also analyzed Conclusions: Addition of preoperative MRI to routine mammography did not have a statistically significant impact on surgical management of newly detected non metastatic breast cancers. No statistically significant difference was noted in the number of lesions detected by sonomammography and MRI.There was significant difference between histologically proven and unproven cases in patients where the treatment plan was changed, i.e. 37.5% (3/8) vs 62.5% (5/8) amongst 08 cases where treatment plan was changed following MRI. Changes in treatment plan accrued higher percentage of negative results on histopathological examination.