| Affiliation: | 1.Department of Biomedical Data Science,Geisel School of Medicine at Dartmouth,Lebanon,USA;2.Norris Cotton Cancer Center,Lebanon,USA;3.The Dartmouth Institute for Health Policy and Clinical Practice,Geisel School of Medicine at Dartmouth,Lebanon,USA;4.Kaiser Permanente Washington Health Research Institute,Seattle,USA;5.Department of Radiology,Stanford University,Palo Alto,USA;6.Division of Health Policy and Management,University of Minnesota,Minneapolis,USA;7.Department of Radiology,The University of North Carolina,Chapel Hill,USA;8.Department of Medicine and Epidemiology and Biostatistics,University of California,San Francisco,USA;9.Department of Biostatistics, Epidemiology and Informatics,University of Pennsylvania,Philadelphia,USA |
| Abstract: | PurposeThe survival benefit from detecting additional breast cancers by preoperative magnetic resonance imaging (MRI) continues to be controversial.MethodsWe followed a cohort of 4454 women diagnosed with non-metastatic breast cancer (stage I–III) from 2/2005–6/2010 in five registries of the breast cancer surveillance consortium (BCSC). BCSC clinical and registry data were linked to Medicare claims and enrollment data. We estimated the cumulative probability of breast cancer-specific and all-cause mortality. We tested the association of preoperative MRI with all-cause mortality using a Cox proportional hazards model.Results917 (20.6%) women underwent preoperative MRI. No significant difference in the cumulative probability of breast cancer-specific mortality was found. We observed no significant difference in the hazard of all-cause mortality during the follow-up period after adjusting for sociodemographic and clinical factors among women with MRI (HR 0.90; 95% CI 0.72–1.12) compared to those without MRI.ConclusionOur findings of no breast cancer-specific or all-cause mortality benefit supplement prior results that indicate a lack of improvement in surgical outcomes associated with use of preoperative MRI. In combination with other reports, the results of this analysis highlight the importance of exploring the benefit of preoperative MRI in patient-reported outcomes such as women’s decision quality and confidence levels with decisions involving treatment choices. |
