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Pre-breast cancer surgery MRI may harm, not help

NEW YORK (Reuters Health) - Preparing as much as possible for surgery would seem to make sense, but in one case -- using magnetic resonance imaging (MRI) to plan breast cancer surgery - it may do more harm than good, according to a new study.

Doctors typically use such MRIs to refine their surgical plans, in an attempt to save the breasts of women having tumors removed. But doing so may actually delay treatment and increase the likelihood that women need a mastectomy - removal of the breast - to cut out the tumors.

“Without evidence of improved...outcomes as a result, our study does not support the routine use of MRI to select patients or facilitate the performance of breast-conserving therapy,” Dr. Richard J. Bleicher, from Fox Chase Cancer Center, Philadelphia, and colleagues write in their study.

The study, reported in the Journal of the American College of Surgeons, featured 577 patients, 130 of whom had a pretreatment MRI. The rate of MRI usage reflected the increasing popularity of the technique, doubling from 13 percent in 2004 to 27 percent in 2006.

Having such an MRI meant an average delay to surgery of more than three weeks, the report indicates.

Usage of MRI increased the odds of mastectomy by 80 percent, and did not improve the ability of surgeons to make sure they had removed the entire tumor.

“Our study sounds a cautionary note that the ‘obvious’ benefits of MRI may not be observed in clinical practice,” the authors conclude.

SOURCE: Journal of the American College of Surgeons, August 2009.

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