Frontiers in Oncology (Mar 2023)

Prospective study: Impact of breast magnetic resonance imaging on oncoplastic surgery and on indications of mastectomy in patients who were previously candidates to breast conserving surgery

  • Karina Furlan Anselmi,
  • Karina Furlan Anselmi,
  • Cicero Urban,
  • Maíra Teixeira Dória,
  • Maíra Teixeira Dória,
  • Linei Augusta Brolini Delle Urban,
  • Ana Paula Sebastião,
  • Flávia Kuroda,
  • Iris Rabinovich,
  • Iris Rabinovich,
  • Alessandra Amatuzzi Fornazari Cordeiro,
  • Leonardo Paese Nissen,
  • Eduardo Schunemann,
  • Eduardo Schunemann,
  • Cleverton Spautz,
  • Julia Di Conti Pelanda,
  • Rubens Silveira de Lima,
  • Mario Rietjens,
  • Marcelo de Paula Loureiro

DOI
https://doi.org/10.3389/fonc.2023.1154680
Journal volume & issue
Vol. 13

Abstract

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BackgroundRoutine use of magnetic resonance imaging (MRI) in the staging of patients with early breast cancer is still controversial. Oncoplastic surgery (OP) allows for wider resections without compromising the aesthetic results. This study aimed to assess the impact of preoperative MRI on surgical planning and on indications of mastectomy.MethodsProspective study including T1-T2 breast cancer patients treated between January 2019 and December 2020 in the Breast Unit of the Hospital Nossa Senhora das Graças in Curitiba, Brazil. All patients had indication for breast conserving surgery (BCS) with OP and did a breast MRI after conventional imaging.Results131 patients were selected. Indication for BCS was based on clinical examination and conventional imaging (mammography and ultrasound) findings. After undergoing breast MRI, 110 patients (84.0%) underwent BCS with OP and 21 (16.0%) had their surgical procedure changed to mastectomy. Breast MRI revealed additional findings in 52 of 131 patients (38%). Of these additional findings, 47 (90.4%) were confirmed as invasive carcinoma. Of the 21 patients who underwent mastectomies, the mean tumor size was 2.9 cm (± 1,7cm), with all having additional findings on breast MRI (100% of the mastectomies group vs 28.2% of the OP, p<0.01). Of the 110 patients submitted to OP, the mean tumor size was 1,6cm (± 0,8cm), with only 6 (5.4%) presenting positive margins at the final pathology assessment.ConclusionPreoperative breast MRI has an impact on the OP scenario, bringing additional information that may help surgical planning. It allowed selecting the group with additional tumor foci or greater extension to convert to mastectomy, with a consequent low reoperation rate of 5.4% in the BCS group. This is the first study to assess the impact of breast MRI in the preoperative planning of patients undergoing OP for the treatment of breast cancer.

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