Dr. David Martinez-Cecilia, a surgeon from the General Surgery Service, directed by Prof. Rufian-Peña, in the Hospital Universitario Reina Sofia, Cordoba, Spain, said that this technique should become standard in determining the stage of the tumour before any operation.
Dr. Martinez-Cecilia and his team studied 249 patients who were undergoing surgery for breast cancer, and carried out routine MRI as soon as a biopsy showed malignancy. If additional lesions were discovered, a further biopsy was carried out on them.
“Using MRI, we found 20 additional malignant lesions in 18 patients”, he said, “and that meant that for 15 patients we were able to change the surgical treatment to one which took care of all the tumours, as opposed to the single one that had originally been diagnosed.” 3 patients needed surgery in both breasts, one required a second lumpectomy in the same breast, and 11 changed from lumpectomy to mastectomy. The surgical treatment also changed in those patients where the MRI showed up a larger tumour than that which was originally identified; 16 other patients changed from lumpectomy to mastectomy, and one from lumpectomy to quadrantectomy, a partial mastectomy where the tumour and some surrounding breast tissue is removed to be sure that the margins around the tumour are cancer-free.
The scientists then carried out a retrospective analysis of the surgical outcomes. “We found that the changes in surgical treatment had been beneficial in 22 patients (9%), non beneficial in 6 patients (2.4%), and uncertain in 4 patients (1.6%)”, said Dr. Martinez-Cecilia. The results also showed us that MRI is the best imaging technique for measuring tumour size, better than mammography or ultrasound. MRI is being used more frequently in breast cancer pre-operative staging these days, and we thought it was important to validate its efficacy.”
MRI is expensive, but with results such as these it should be used as widely as possible pre-surgery, say the scientists. “It will not only improve the surgical treatment, which was our main aim, but in the long run it will probably reduce costs to healthcare systems by allowing us to identify exactly what needs to be treated, and in what way, to avoid possible recurrences of the cancer and the costs associated with its treatment,” said Dr. Martinez-Cecilia. “We will continue working prospectively with this issue as we would like to see MRI become a standard preoperative treatment for breast cancer, along with biopsy, mammography, and ultrasound.”
Mary Rice | alfa
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