A new study has found that using magnetic resonance imaging (MRI), in addition to mammography, before or immediately after a lumpectomy (surgical removal of the tumor and a small, cancer-free margin of tissue around the tumor) was not linked to a decrease in how often women with ductal carcinoma in situ (DCIS) of the breast experienced a local recurrence (cancer that comes back in the same area of the breast after treatment) or contralateral breast cancer (a new tumor that develops in the other breast).
Some doctors regularly use MRI to determine the size and location of the cancer before surgery in women with DCIS, while others use MRI to get more information after mammography or an ultrasound. On occasion, a woman may have an MRI after surgery to look for any remaining cancer in the breast and/or plan a future surgery if cancer cells were found in the surrounding tissue margin after a lumpectomy. However, there are no published guidelines about the use of MRI in women with newly diagnosed breast cancer. Therefore, the use of MRI for patients with breast cancer varies by hospital and individual surgeon.
In this study, 2,321 women who underwent a lumpectomy for DCIS were evaluated. Of these women, 596 had an MRI either before or immediately after surgery and 1,725 did not. After five years, there was no difference in the number of times the cancer came back at or near the original breast cancer site between the two groups of women (9% with MRI compared to 7% without MRI). The eight-year recurrence rates were also not significantly different (15% versus 10%).
What this means for patients
“We now have a lot of evidence that indicates MRI isn’t necessary for every patient with DCIS,” said lead study author Melissa L. Pilewskie, MD, a breast surgeon at Memorial Sloan-Kettering Cancer Center in New York City and Commack, New York. “Aside from the cost of the test, MRI has a rather high false positive rate, which may result in additional biopsies and a delay in surgery.”
Questions to Ask Your Doctor
- What type and stage of breast cancer do I have? What does this mean?
- Do I need to have any additional tests or scans? Why or why not?
- What are my treatment options? Is lumpectomy an option?
- How long will it be before I know if I need another surgery to remove more tissue?
- What is the risk of the disease returning?
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