The Added Value of Preoperative Magnetic Resonance Imaging of Breast in Surgical Decision

Main Article Content

Marwa Makboul
Shimaa Farghaly
Murad A Jabir
Ramy A Hassan
Mahmoud Refaat Shehata


Breast, Magnetic resonance imaging, Ultrasound, Mammography, Oncoplastic breast surgery


Background: Breast MRI has demonstrated excellent sensitivity in determining the extent of breast cancer and occult malignancy. This study aimed to evaluate the added value of breast MRI compared to mammography and ultrasonography in surgical decision.
Methods: A cross-sectional study was conducted on 84 female patients with newly diagnosed breast cancer by ultrasonography and mammography where conservative breast surgery was initially considered, and then bilateral breast MRI was performed and the multidisciplinary decision was revised. The data was analyzed to determine the additional value of breast MRI in treatment planning.
Results: Eighty-four patients were included of whom 44 (52.4%) patients had additional findings on MRI. The treatment plan was changed after the second ultrasonography and histopathology in 44 patients (52.4%) with a remarkable increase in the rate of modified radical mastectomy after MRI.
Conclusion: Preoperative breast MRI has great value in defining the surgical decision in patients with early breast cancer.


1. Ong E. Preoperative imaging for breast conservation surgery-do we need more than conventional imaging for local disease assessment? Gland Surg. 2018;7(6):554-9.
2. Macmillan RD, McCulley SJ. Oncoplastic Breast Surgery: What, When and for Whom? Curr Breast Cancer Rep. 2016;8:112-7.
3. Perono Biacchiardi C, Brizzi D, Genta F, Zanon E, Camanni M, Deltetto F. Breast cancer preoperative staging: does contrast-enhanced magnetic resonance mammography modify surgery? Int J Breast Cancer. 2011;2011:757234.
4. Drew PJ, Chatterjee S, Turnbull LW, Read J, Carleton PJ, Fox JN, et al. Dynamic contrast enhanced magnetic resonance imaging of the breast is superior to triple assessment for the pre-operative detection of multifocal breast cancer. Ann Surg Oncol. 1999;6(6):599-603.
5. Bilimoria KY, Cambic A, Hansen NM, Bethke KP. Evaluating the impact of preoperative breast magnetic resonance imaging on the surgical management of newly diagnosed breast cancers. Arch Surg. 2007;142(5):441-5; discussion 5-7.
6. Wernli KJ, DeMartini WB, Ichikawa L, Lehman CD, Onega T, Kerlikowske K, et al. Patterns of breast magnetic resonance imaging use in community practice. JAMA Intern Med. 2014;174(1):125-32.
7. Fajdic J, Djurovic D, Gotovac N, Hrgovic Z. Criteria and procedures for breast conserving surgery. Acta Inform Med. 2013;21(1):16-9.
8. Hicks G, Turton P, Rajan S, Nunn A, Sharma N, Achuthan R. The role of magnetic resonance imaging in preoperative planning for patients undergoing therapeutic mammoplasty. ISRN Oncol. 2013;2013:260260.
9. Berg WA, Gutierrez L, NessAiver MS, Carter WB, Bhargavan M, Lewis RS, et al. Diagnostic accuracy of mammography, clinical examination, US, and MR imaging in preoperative assessment of breast cancer. Radiology. 2004;233(3):830-49.
10. Pediconi F, Catalano C, Padula S, Roselli A, Moriconi E, Dominelli V, et al. Contrast-enhanced magnetic resonance mammography: does it affect surgical decision-making in patients with breast cancer? Breast Cancer Res Treat. 2007;106(1):65-74.
11. Fischer U, Kopka L, Grabbe E. Breast carcinoma: effect of preoperative contrast-enhanced MR imaging on the therapeutic approach. Radiology. 1999;213(3):881-8.
12. Grobmyer SR, Mortellaro VE, Marshall J, Higgs GM, Hochwald SN, Mendenhall NP, et al. Is there a role for routine use of MRI in selection of patients for breast-conserving cancer therapy? J Am Coll Surg. 2008;206(5):1045-50; discussion 50-2.
13. Mann RM, Hoogeveen YL, Blickman JG, Boetes C. MRI compared to conventional diagnostic work-up in the detection and evaluation of invasive lobular carcinoma of the breast: a review of existing literature. Breast Cancer Res Treat. 2008;107(1):1-14.
14. Pettit K, Swatske ME, Gao F, Salavaggione L, Gillanders WE, Aft RL, et al. The impact of breast MRI on surgical decision-making: are patients at risk for mastectomy? J Surg Oncol. 2009;100(7):553-8.

Article Statistics :Views : 161 | Downloads : 146 : 1