Influence of Preoperative Magnetic Resonance Imaging in Surgical Planning for Breast Cancer

Assessment of efficacy of preoperative magnetic resonance imaging (pMRI) is important to improve the diagnosis and treatment results in patients with breast cancer (BC). We designed this study to determine the role of pMRI in surgical planning for patients suffering from BC. We, cross sectionally, observed 98 women with BC referring to an educational hospital in Tehran from January 2014 to December 2015. Data pertaining age, pathological type of BC, preoperative imaging findings, and surgical planning were gathered. The frequency of plan alteration was determined according to pMRI findings and analyzed, using appropriate statistical analyses (descriptive statistics, independent t-test, Chi-square, and Fisher’s exact tests). Initial surgical plan of 23 patients (23.47%) was changed. Pathological diagnosis of BC (P = 0.460), size of lesion (P = 0.696), laterality (P = 0.139), and lymph node involvement (P = 0.094) did not seem to alter the surgical plan. On the contrary, younger age (P = 0.049), more lesions (P = 0.002), pMRI enhancement curve washout pattern (P = 0.020), and multifocality (P < 0.001) of lesions in pMRI seemed to change surgical treatment plan. Yet, neither ultrasonography nor mammography findings did alter the plan (P > 0.050). pMRI findings, including multiple lesions and multifocal involvement showing enhancement pattern suggestive for malignancy, may change surgical planning in about a quarter of women suffering from BC, particularly the younger ones, but MRI is not mere criterion for determining and usage of it should be limited to necessary subjects because when it is done without strict parameters, it will cause over diagnosis and over treatment.