Surgical attitudes toward preoperative breast magnetic resonance imaging in women with early-stage breast cancer

S. D. Mukherjee, N. Hodgson, P. J. Lovrics, K. Dhamanaskar, S. Chambers, J. Sussman

Abstract


Background Preoperative breast magnetic resonance imaging (mri) is commonly requested by surgeons in the initial workup of women with breast cancer; however, its use is controversial. We performed a survey of breast cancer surgeons across Canada to investigate current knowledge about, attitudes to, and self-reported use of preoperative breast mri in a publicly funded health care system in light of the limited evidence to support it.

Methods All identified general surgeons in Canada were mailed a survey instrument designed to probe current practice and knowledge of published trials.

Results Of 403 responding surgeons, 233 (58%) indicated that they performed breast cancer surgery. Of those 233, 218 (94%) had access to breast mri and completed the entire survey. Overall, 54.6% of responding surgeons felt that breast mri was useful in surgical planning, and more than half (58.3%) indicated that their frequency of use was likely to increase over the next 5 years. Surgeons found preoperative mri most useful in detecting mammographically occult disease (71.5% of respondents) and in planning for breast-conserving surgery (57.3%). The main limitations reported were timely access to mri (51%) and false positives (36.7%). Responses suggest a knowledge gap in awareness of published trials in breast mri.

Conclusions Our study found that, in early-stage breast cancer, self-reported use of mri by breast cancer surgeons in Canada varied widely. Reported indications did not align with published data, and significant gaps in self-reported knowledge of the data were evident. Our results would support the development and dissemination of guidelines to optimize use of mri.


Keywords


Preoperative; Breast Cancer; Magnetic Resonance Imaging

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DOI: http://dx.doi.org/10.3747/co.26.4227






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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)