{"id":7743,"date":"2023-12-05T08:58:32","date_gmt":"2023-12-05T08:58:32","guid":{"rendered":"https:\/\/www.library.sath.nhs.uk\/research\/?p=7743"},"modified":"2025-07-29T10:08:45","modified_gmt":"2025-07-29T09:08:45","slug":"magnetic-resonance-imaging-before-breast-cancer-surgery-results-of-an-observational-multicenter-international-prospective-analysis-mipa-2022","status":"publish","type":"post","link":"https:\/\/www.library.sath.nhs.uk\/research\/2023\/12\/05\/magnetic-resonance-imaging-before-breast-cancer-surgery-results-of-an-observational-multicenter-international-prospective-analysis-mipa-2022\/","title":{"rendered":"Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA) (2022)"},"content":{"rendered":"

Type of publication:<\/strong>
Journal article<\/p>\n

Author(s):<\/strong>
Sardanelli F, Trimboli RM, Houssami N, Gilbert FJ, Helbich TH, \u00c1lvarez Benito M, Balleyguier C, Bazzocchi M, Bult P, Calabrese M, Camps Herrero J, Cartia F, Cassano E, Clauser P, Cozzi A, de Andrade DA, de Lima Docema MF, Depretto C, Dominelli V, Forrai G, Girometti R, Harms SE, Hilborne S, Ienzi R, Lobbes MBI, Losio C, Mann RM, Montemezzi S, Obdeijn IM, *Ozcan Umit A, Pediconi F, Pinker K, Preibsch H, Raya Povedano JL, Sacchetto D, Scaperrotta GP, Schiaffino S, Schlooz M, Szab\u00f3 BK, Taylor DB, Ulus \u00d6S, Van Goethem M, Veltman J, Weigel S, Wenkel E, Zuiani C, Di Leo G.<\/p>\n

Citation:<\/strong>
European Radiology. 2022 Mar;32(3):1611-1623.<\/p>\n

Abstract:<\/strong>
Objectives: Preoperative breast magnetic resonance imaging (MRI) can inform surgical planning but might cause overtreatment by increasing the mastectomy rate. The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue. Methods: This observational study enrolled women aged 18-80 years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and\/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers. Exclusion criteria included planned neoadjuvant therapy, pregnancy, personal history of any cancer, and distant metastases. Results: Of 5896 analyzed patients, 2763 (46.9%) had conventional imaging only (noMRI group), and 3133 (53.1%) underwent MRI that was performed for diagnosis, screening, or unknown purposes in 692\/3133 women (22.1%), with preoperative intent in 2441\/3133 women (77.9%, MRI group). Patients in the MRI group were younger, had denser breasts, more cancers \u2265 20 mm, and a higher rate of invasive lobular histology than patients who underwent conventional imaging alone (p < 0.001 for all comparisons). Mastectomy was planned based on conventional imaging in 22.4% (MRI group) versus 14.4% (noMRI group) (p < 0.001). The additional planned mastectomy rate in the MRI group was 11.3%. The overall performed first- plus second-line mastectomy rate was 36.3% (MRI group) versus 18.0% (noMRI group) (p < 0.001). In women receiving conserving surgery, MRI group had a significantly lower reoperation rate (8.5% versus 11.7%, p < 0.001). Conclusions: Clinicians requested breast MRI for women with a higher a priori probability of receiving mastectomy. MRI was associated with 11.3% more mastectomies, and with 3.2% fewer reoperations in the breast conservation subgroup. Key points: \u2022 In 19% of patients of the MIPA study, breast MRI was performed for screening or diagnostic purposes. \u2022 The current patient selection to preoperative breast MRI implies an 11% increase in mastectomies, counterbalanced by a 3% reduction of the reoperation rate. \u2022 Data from the MIPA study can support discussion in tumor boards when preoperative MRI is under consideration and should be shared with patients to achieve informed decision-making.<\/p>\n

Link to full-text<\/a> [open access - no password required]<\/p>\n

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