Association of routine pretreatment magnetic resonance imaging with time to surgery, mastectomy rate, and margin status.
Association of routine pretreatment magnetic resonance imaging with time to surgery, mastectomy rate, and margin status.
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DOI：
10.1016/j.jamcollsurg.2009.04.010
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发表时间：
2009-08
影响因子：
5.2
通讯作者：
Morrow, Monica
中科院分区：
文献类型：
--
作者：
Bleicher, Richard J.;Ciocca, Robin M.;Egleston, Brian L.;Sesa, Linda;Evers, Kathryn;Sigurdson, Elin R.;Morrow, Monica
乳房MRI对新诊断的乳腺癌患者的益处尚不确定。这项研究描述了接受MRI的患者与未接受MRI的患者的特征，并报告了他们的短期手术结局，包括手术时间、边缘状态和乳房切除率。回顾性分析了2004年7月至2006年12月在多学科乳腺癌诊所就诊的所有患者。由放射科医生、病理科医生、外科医生、放射科医生和内科肿瘤学家对患者进行评价。在577例患者中，130例接受了治疗前MRI检查。MRI的使用从2004年（参考，13%）增加到2005年（24%，p=0.014）和2006年（27%，p=0.002）。接受MRI检查的患者较年轻（52.5岁vs 59.0岁，p<0.001），但其使用与术前化疗、乳腺癌或卵巢癌家族史、临床表现或肿瘤特征无关。MRI与治疗前评价延迟22.4天相关（p=0.011）。在419例具有完整手术数据的患者中，有320例尝试了BCT。控制T大小和分期，MRI后乳房切除术与未行MRI相比的比值比为1.80（p=0.024）。接受MRI的患者在乳房肿瘤切除术时的阳性切缘并不减少（21.6%-MRI vs. 13.8%-无MRI，p=0.20），或从BCT转换为乳房切除术（9.8%-MRI vs. 5.9%-无MRI，p=0.35）。乳腺MRI的使用并不局限于任何特定的患者群体。MRI的使用与边缘状态改善或BCT尝试无关，但与治疗延迟和乳房切除率增加相关。由于没有证据表明肿瘤学结局得到改善，我们的研究不支持常规使用MRI选择患者或促进BCT的实施。
The benefit of breast MRI for newly diagnosed breast cancer patients is uncertain. This study characterized those receiving MRI versus those who did not, and reports on their short term surgical outcomes, including time to surgery, margin status, and mastectomy rate. All patients seen in a multidisciplinary breast cancer clinic from July 2004 to December 2006 were retrospectively reviewed. Patients were evaluated by a radiologist, pathologist, and surgical, radiation, and medical oncologists. Among 577 patients, 130 had pre-treatment MRIs. MRI use increased from 2004 (referent, 13%) versus 2005 (24%, p=0.014) and 2006 (27%, p=0.002). Patients having MRIs were younger (52.5 vs 59.0 y, p<0.001), but its use was not associated with preoperative chemotherapy, family history of breast or ovarian cancer, presentation, or tumor features. MRI was associated with a 22.4-day delay in pre-treatment evaluation (p=0.011). BCT was attempted in 320 of 419 patients with complete surgical data. The odds ratio for mastectomy, controlling for T size and stage, was 1.80 after MRI vs. no MRI (p=0.024). Patients having MRIs did not have fewer positive margins at lumpectomy (21.6%-MRI vs. 13.8%-no MRI, p=0.20), or conversions from BCT to mastectomy (9.8%-MRI vs. 5.9%-no MRI, p=0.35). Breast MRI use was not confined to any particular patient group. MRI use was not associated with improved margin status or BCT attempts, but was associated with a treatment delay and increased mastectomy rate. Without evidence of improved oncologic outcome as a result, our study does not support the routine use of MRI to select patients or facilitate the performance of BCT.
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影响因子：
5
作者：
Bassett, Lawrence W.;Dhaliwal, Sonia G.;Sayre, James W.
通讯作者：
Sayre, James W.
影响因子：
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作者：
Bilimoria, Karl Y.;Cambic, Angela;Bethke, Kevin P.
通讯作者：
Bethke, Kevin P.
影响因子：
158.5
作者：
Kriege, M;Brekelmans, CTM;Klijn, JGM
通讯作者：
Klijn, JGM
影响因子：
45.3
作者：
Wapnir, IL;Anderson, SJ;Wolmark, N
通讯作者：
Wolmark, N
DOI：
10.1016/j.jamcollsurg.2007.12.039
发表时间：
2008-05-01
影响因子：
5.2
作者：
Grobmyer, Stephen R.;Mortellaro, Vincent E.;Cance, William G.
通讯作者：
Cance, William G.