Pre-op MRIs don't significantly affect margin status in breast cancer patients

Preoperative magnetic resonance imaging does not "significantly reduce positive margins" following breast-conserving surgery, according to trial study findings published July 10 in The Asco Post.

While MRI revealed additional breast cancer in 16 percent of the study participants, it showed that MRI after surgery "was not associated with clear tumor margins," the article said. "Conversely, patient age and tumor size were found to be critical factors in predicting margin status."

Two randomized study trials, SHAVE and SHAVE2, were conducted at 10 hospitals with 631 female patients diagnosed with stage 0 to stage 3 breast cancer who had breast-conserving surgery.

In addition to greater morbidity and "healthcare system overload," reexcision surgery may contribute to patient anxiety and poor cosmetic outcomes, Marissa Howard-McNatt, MD, professor of surgery and director of the Atrium Health Wake Forest Baptist Comprehensive Cancer Center in Winston-Salem, N.C., said in the article.

"MRI exams are costly and potentially stressful for patients," study author Dr. Howard-McNatt said. "The thought is that they will help physicians achieve negative margins during the initial surgery. However, our study shows this is not the case."

Study findings were presented at the 2023 American Society of Breast Surgeons Annual Meeting.

"No one wants to take a patient back to the operating room. Advances in surgical techniques and technology ... may prove successful in adding precision to breast cancer surgery," Dr. Howard-McNatt said. 



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