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KMID : 1114620210180020081
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Journal of the Korean Society for Breast Screening
2021 Volume.18 No. 2 p.81 ~ p.93
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Relationship between Pre-Operative Breast Magnetic Resonance Imaging-Detected Additional Cancer and Survival Outcomes: A Retrospective Multi-Center Study
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Choi Hye-Young
Ko Eun-Sook
Lim Yae-Ji
Ahn So-Young
Lee Jeong-Eon
Kim Seok-Won
Yu Jong-Han
Han Boo-Kyung
Ko Eun-Young
Choi Ji-Soo
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Abstract
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Purpose: To determine the additional cancer detection yield of pre-operative magnetic resonance imaging (MRI) in women with invasive breast cancer that was occult on mammography and ultrasonography (US), identify women with likelihood to develop MRI-detected additional cancer (MDAC), and compare long-term outcomes between patients without pre-operative MRI and those with preoperative MRI or MDAC.
Materials and Methods: This retrospective multi-institutional study was conducted between January 2010 and December 2012. Among 2,104 women who had undergone surgery for invasive breast cancer, pre-operative MRI examinations of 1,808 women were reviewed for the presence of MDAC. Logistic regression analysis was conducted to determine factors associated with MDACs. We identified patients with unilateral breast cancer who underwent breast-conserving surgery (BCS) with radiation therapy and compared disease-free survival (DFS) between patients with and without pre-operative MRI and between patients with MDACs and without MRI, using Cox proportional hazards model and KaplanMeier curve analyses.
Results: Of 1,808 patients, 174 (9.6%) had MDAC. Multivariate analysis showed that invasive lobular cancer (ILC) (odds ratio: 2.522, 95% confidence interval [CI]: 1.281, 4.647; P = .005) and premenopausal status (odds ratio, 1.471; 95% CI: 1.063, 2.054; P = .022) were independently associated with higher probability of MDAC. Patients with pre-operative MRI or MDAC were not significantly associated with better DFS as compared to those without MRI (P = .229 and .693, respectively).
Conclusion: ILC and premenopausal status were associated with greater likelihood of pre-operative MRI to detect MDAC. However, pre-operative MRI had no significant impact on DFS.
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KEYWORD
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Breast, Breast Cancer, Magnetic resonance imaging, Prognosis, Survival
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