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The study: Researchers at the Mayo Clinic in Rochester, Minnesota looked at how the use of magnetic resonance imaging (MRI) before surgery affected the number of women with early-stage breast cancer who had a mastectomy (removal of the breast as a treatment for breast cancer) instead of a lumpectomy (removal of the tumor and a small, cancer-free area around the tumor) between 1997 and 2006. Lumpectomy plus radiation therapy is a common treatment for women with early-stage (stage I and II) breast cancer and has been shown to be as effective as mastectomy. When MRI is used before surgery, it may find cancer in more than one part of the breast, leading women and their doctors to choose mastectomy more often than lumpectomy. However, about half of the possible tumors that show up on MRI are noncancerous and only need to be monitored.
The results: Between 2003 and 2006, the number of mastectomies performed at the Mayo Clinic increased from 30% to 43%. During this time, the number of women who received MRI before surgery also increased, from 11% to 22%. Of the women who had MRI before surgery, 52% had a mastectomy, compared with 38% of women who did not have MRI, showing that women who received MRI before surgery were more likely to have a mastectomy. Mastectomy rates also increased for women who did not have MRI, from 28% in 2003 to 41% in 2006, suggesting that other factors may contribute to the increase in mastectomy rates.
What this means for patients
“This study shows that many women with early-stage breast cancer are undergoing mastectomy, and it appears to be partially related to the use of MRI before surgery,” said lead author Rajini Katipamula, MD, Senior Clinical Fellow in Hematology/Oncology at the Mayo Clinic. Women should talk with their doctor about the benefits and side effects of mastectomy versus lumpectomy and radiation therapy.
What to ask your doctor
- Would you explain my surgical treatment options to me?
- Do I need a mastectomy, or am I a candidate for lumpectomy?
- What are the possible short-term and long-term side effects of these treatments?
- How is a noncancerous tumor found on an MRI monitored?
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