Role of magnetic resonance imaging and magnetic resonance imaging-guided surgery in the evaluation of patients with early-stage breast cancer for breast conservation treatment

Magnetic resonance imaging (MRI) may be more sensitive than mammography for detecting breast cancer and may have an adjunctive role in assessing patie nts with early-stage disease for breast conservation treatment. This study was performed to analyze the impact of breast MRI on the clinical managemen t of 83 patients being considered for breast conservation treatment. Eighty -three consecutive cases of patients undergoing breast MRI during standard workup and evaluation for breast conservation treatment from 1993 to 1996 w ere retrospectively reviewed. Records were reviewed for patient and tumor c haracteristics, mammographic findings, MRI findings, timing of MRI study, f indings from MRI-guided surgery (when done), and whether the patient underw ent breast conservation treatment. MRI definitely altered management in 15 patients (18%), may have affected management in 4 patients (5%), and did no t change management in 64 patients (77%). Thirteen patients underwent addit ional surgery because of MRI findings; the positive predictive value for MR I-guided surgery was 38% (5 of 13). Ultimately, 82% of the patients receive d breast conservation treatment. No predictive factor was identified to cha racterize the patients most likely to have management affected by MRI findi ngs. These findings suggest that breast MRI may be useful in the evaluation of patients with early-stage breast cancer for breast conservation treatme nt. A larger study population and outcome data will be required to confirm these findings and to define those patients most likely to benefit from bre ast MRI.