The review, appearing early online in CA: A Cancer Journal for Clinicians, says evidence shows that MRI increases the chances of more extensive surgery over conservative approaches, with no evidence that it improves surgical care or prognosis.
Randomized controlled trials have shown women with early stage breast cancer who are treated with breast-conservation therapy (local excision and radiotherapy) have the same survival rates as those who undergo mastectomy. Recently, MRI has been introduced in preoperative staging of the affected breast in women with newly diagnosed breast cancer because it detects additional areas of cancer that do not show up on conventional imaging. In the current review, Nehmat Houssami, MBBS, Ph.D., of the University of Sydney, Australia, and Daniel F. Hayes, M.D., of University of Michigan Comprehensive Cancer Center, Ann Arbor, Mich., reviewed available data on preoperative MRI's detection capability and its impact on treatment. The use of preoperative MRI scans in women with early stage breast cancer has been based on assumptions that MRI's detection capability in this setting will improve surgical treatment by improving surgical planning, potentially leading to a reduction in re-excision surgery, and by guiding surgeons to remove additional disease detected by MRI and potentially reducing recurrence in the treated breast. The authors say emerging data show that this approach to local staging of the breast leads to more women being treated with mastectomy without evidence of improvement in surgical outcomes or long-term prognosis.
After reviewing the data, the authors conclude that there is evidence that MRI changes surgical management, generally from breast conservation to more radical surgery, but that there is no evidence that it improves surgical treatment or outcomes. "Overall, there is growing evidence that MRI does not improve surgical care, and it could be argued that it has a potentially harmful effect," conclude the authors. They say well-designed, randomized controlled trials are needed to quantify potential benefit and harm, including careful evaluation of its impact on quality of life. "We acknowledge that logistics and costs of conducting such large-scale, multicenter trials are enormous. If the technology is truly as beneficial as its proponents claim, then these costs are worth it. If it is not, then they are outweighed by the costs of adopting expensive technology and associated intervention without evidence of clinical benefit," they conclude.
Article: "Review of Preoperative Magnetic Resonance Imaging (MRI) in Breast Cancer," Nehmat Houssami, MBBS, PhD, and Daniel F. Hayes, MD, CA Cancer J Clin Published Online: August 13, 2009 (doi:10.3322/caac.20028); Print Issue Date: September/October 2009.
David Sampson | EurekAlert!
PET identifies which prostate cancer patients can benefit from salvage radiation treatment
05.12.2017 | Society of Nuclear Medicine and Molecular Imaging
Designing a golden nanopill
01.12.2017 | University of Texas at Austin, Texas Advanced Computing Center
DNA molecules that follow specific instructions could offer more precise molecular control of synthetic chemical systems, a discovery that opens the door for engineers to create molecular machines with new and complex behaviors.
Researchers have created chemical amplifiers and a chemical oscillator using a systematic method that has the potential to embed sophisticated circuit...
MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.
Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...
Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...
Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.
To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...
The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.
Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...
11.12.2017 | Event News
08.12.2017 | Event News
07.12.2017 | Event News
15.12.2017 | Power and Electrical Engineering
15.12.2017 | Materials Sciences
15.12.2017 | Life Sciences