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MRI Linked To Increased Breast Cancer Surgery

August 16, 2013
Written by: , Filed in: Breast Imaging, Medical Ethics
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When older women with breast cancer get an MRI scan, they are more likely to receive aggressive surgical treatment—such as the removal of both breasts—that may not be necessary, according to a new study by Yale School of Medicine researchers.

The study’s senior author, Cary P. Gross, MD, said in a Yale news release:

These data are concerning because the long-term benefits associated with bilateral mastectomy for older women with breast cancer are unclear.

Dr. Gross is associate professor of internal medicine at Yale School of Medicine and director of the Cancer Outcomes, Public Policy, and Effectiveness Research Center (COPPER) at Yale Cancer Center.

The study, reported online this month in Breast Cancer Research and Treatment, used the Surveillance, Epidemiology and End Results-Medicare database to examine breast MRI and surgery among 72,461 female Medicare beneficiaries ages 67–94 who were diagnosed with breast cancer in 2000–2009.

Use of preoperative breast MRI boomed during the study period, increasing from 1 percent in 2000–2001 to 25 percent in 2008–2009. Its use seemed to be associated with more-aggressive surgery. Among women who received mastectomy, 12.5 of those who had MRI received a double mastectomy; only 4.1 percent of those who did not have MRI underwent the same surgery.

Also among women who had mastectomy, 6.9 percent of those who had MRI underwent prophylactic removal of both breasts when cancer was found in only one; among those who did not have MRI, the rate of such surgery was 1.8 percent.

“There has been no randomized controlled clinical trial demonstrating improved outcomes for women who undergo preoperative breast MRI at any age,” said Brigid K. Killelea, MD, lead author of the study and assistant professor of surgery at Yale School of Medicine. “Breast-conserving therapy, when feasible, remains the preferred approach for women with early-stage breast cancer.”

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Can a school ban a breast cancer awareness bracelet with a deliberately provocative message? No, says a federal appeals court. For details, see our Facebook page.

Related CME seminar (up to 39.25 AMA PRA Category 1 credits™): Comprehensive Review of Breast Imaging (new release)


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