Outcomes after Surgery for Early Stage Breast Cancer in Women Staged With Preoperative Breast Magnetic Resonance Imaging According to Breast Tissue Density

Renata Faermann; Jonathan Weidenfeld; Leonid Chepelev; Wayne Kendal; Raman Verma; Andrew Scott-Moncrieff; Susan Peddle; Geoff Doherty; Jackie Lau; Tim Ramsay; Angel Arnaout; Leslie Lamb; James M Watters; Jean M Seely

doi:10.1093/jbi/wbz018

Outcomes after Surgery for Early Stage Breast Cancer in Women Staged With Preoperative Breast Magnetic Resonance Imaging According to Breast Tissue Density

J Breast Imaging. 2019 Jun 4;1(2):115-121. doi: 10.1093/jbi/wbz018.

Authors

Renata Faermann¹, Jonathan Weidenfeld¹, Leonid Chepelev¹, Wayne Kendal^{2

3}, Raman Verma¹, Andrew Scott-Moncrieff¹, Susan Peddle¹, Geoff Doherty¹, Jackie Lau¹, Tim Ramsay^{2

4}, Angel Arnaout^{2

5}, Leslie Lamb¹, James M Watters⁵, Jean M Seely¹

Affiliations

¹ Ottawa Hospital, Department of Medical Imaging, University of Ottawa, Ottawa, ON, Canada.
² Ottawa Hospital Research Institute, Ottawa, ON, Canada.
³ Ottawa Hospital, Department of Radiation Oncology, University of Ottawa, Ottawa, ON, Canada.
⁴ Epidemiology, Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada.
⁵ Ottawa Hospital, Department of Surgery, Ottawa, ON, Canada.

PMID: 38424925
DOI: 10.1093/jbi/wbz018

Abstract

Purpose: To determine surgical outcomes and breast cancer disease-free survival outcomes of women with early stage breast cancer with and without use of preoperative breast MRI according to breast tissue density.

Methods: Women with early stage breast cancer diagnosed from 2004 to 2009 were classified into 2 groups: 1) those with dense and heterogeneously dense breasts (DB); 2) those with nondense breasts (NDB) (scattered fibroglandular and fatty replaced tissue). The 2 groups were reviewed to determine who underwent preoperative MRI. Breast tissue density was determined with mammography according to ACR BI-RADS. Patients were compared according to tumor size, grade, stage, and treatment. Survival analysis was performed using Kaplan-Meier estimates.

Results: In total, 261 patients with mean follow-up of 85 months (25-133) were included: 156 DB and 105 NDB. Disease-free survival outcomes were better in the DB group in patients with MRI than in those without MRI: patients with MRI had significantly fewer local recurrences (P < 0.016) and metachronous contralateral breast cancers (P < 0.001), but this was not the case in the NDB group. Mastectomies were higher in the DB group with preoperative MRI than in those without MRI (P < 0.01), as it was in the NDB group (P > 0.05).

Conclusions: Preoperative breast MRI was associated with reduced local recurrence and metachronous contralateral cancers in the DB group, but not in the NDB group; however, the DB patients with MRI had higher mastectomy rates.

Keywords: breast MRI; breast cancer; breast tissue density; outcome; survival.