Preoperative breast MRI and mortality in older women with breast cancer

T. Onega, W. Zhu, J. E. Weiss, M. Goodrich, A. N.A. Tosteson, W. DeMartini, B. A. Virnig, L. M. Henderson, D. S.M. Buist, K. J. Wernli, K. Kerlikowske, R. A. Hubbard

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The survival benefit from detecting additional breast cancers by preoperative magnetic resonance imaging (MRI) continues to be controversial. Methods: We 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. Results: 917 (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. Conclusion: Our 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.

Original languageEnglish (US)
Pages (from-to)149-157
Number of pages9
JournalBreast Cancer Research and Treatment
Volume170
Issue number1
DOIs
StatePublished - Jul 1 2018

Bibliographical note

Funding Information:
We conducted this study at six breast cancer surveillance consortium (BCSC) breast screening registries sponsored by the National Cancer Institute (BCSC; http://bcsc-research. org/): in New Hampshire, New Mexico, North Carolina, San Francisco, Vermont, and Western Washington State (Kaiser Permanente Washington Registry), which send data to the Statistical Coordinating Center (SCC) for pooling and analysis [14]. The BCSC collects risk factor, clinical history, and sociodemographic data for women receiving breast imaging exams within the registries, which are further linked to both benign and malignant breast pathology outcomes, cancer registry data, and vital status.

Funding Information:
Acknowledgements This research was supported by a National Cancer Institute-funded grant R01CA149365. Data collection for this work was additionally supported, in part, by funding of the Breast Cancer Surveillance Consortium from the National Cancer Institute (P01CA154292, U54CA163303). The collection of cancer and vital status data used in this study was supported in part by several state public health departments and cancer registries throughout the U.S. For a full description of these sources, please see: http://www.bcscr esearch.org/work/acknowledgement.html. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. We thank the participating women, mammography facilities, and radiologists for the data they have provided for this study. You can learn more about the breast cancer surveillance consortium at: http:// www.bcscresearch.org/.

Funding Information:
Funding This research was supported by a National Cancer Institute-funded grant R01CA149365. Data collection for this work was additionally supported, in part, by funding of the Breast Cancer Surveillance Consortium from the National Cancer Institute (P01CA154292, U54CA163303).

Keywords

  • Breast cancer
  • Breast cancer mortality
  • Breast cancer treatment
  • Preoperative breast MRI

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