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Preoperative Breast Magnetic Resonance Imaging

ID: ES 1-25 Dec 2021
Type of Content: Guidelines & Advice
Document Status: Current
Andrea Eisen, Glenn G Fletcher, Samantha Fienberg, Ralph George, Claire Holloway, Supriya Kulkarni, Jean Seely, Derek Muradali

Guideline Objective:

The objective is to summarize the literature comparing patient outcomes with and without preoperative Breast MRI. This summary will provide guidance to The Breast Cancer Advisory Committee in updating the Breast Cancer Disease Pathway.

Patient Population:

Patients diagnosed with breast cancer for which additional information on disease location or extent obtained prior to surgery may influence staging, treatment, or prognosis. Individuals at high risk of breast cancer who have already had MRI as part of screening are not included in the current review.

Intended Guideline Users:

  1. The primary users will be members of the Breast Cancer Advisory Committee, OH (CCO) staff, and others involved in completion of the breast cancer pathway. The topic is also within the mandate of the Cancer Imaging Program of OH (CCO).
  2. This review may also be of interest to general practitioners, radiologists, medical oncologists, surgical oncologists, and radiation oncologists.

Research Questions:

In patients with newly diagnosed breast cancer, does additional information on extent of disease obtained by use of preoperative breast MRI after mammography and/or ultrasound (a) change the type or extent of surgery (breast conserving surgery [BCS], unilateral or bilateral mastectomy), type or extent of radiation therapy, or use of adjuvant therapy; (b) improve patient outcomes such as recurrence, disease- or event-free survival (DRD, EFS), distant metastasis-free survival (DMFS), overall survival (OS), rates of re-excision or re-operation, or quality of life?

A secondary objective of this review was to provide technical guidance on use of MRI by listing documents of possible relevance and summarizing some of the issues affecting imaging selection and performance.