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Title of Journal: Breast Cancer Res Treat

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Abbravation: Breast Cancer Research and Treatment

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Springer US

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DOI

10.1002/pen.760330103

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ISSN

1573-7217

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Preoperative breast MRI in earlystage breast canc

Authors: Patricia Young Benjamin Kim Jennifer L Malin
Publish Date: 2012/08/26
Volume: 135, Issue: 3, Pages: 907-912
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Abstract

Rapid uptake of new imaging technology is a major contributor to rising healthcare costs Preoperative breast magnetic resonance imaging MRI for patients with earlystage breast cancer has dramatically increased in use without the evidence of improved outcomes compared to standard assessment and is associated with higher rates of mastectomy A decision analytic model was developed to evaluate the impact of adding breast MRI to the preoperative evaluation of women with earlystage breast cancer who were candidates for breastconserving therapy on patient outcomes measured in qualityadjusted life years QALYs Model inputs including survival recurrence rates and health utilities were obtained from a comprehensive literature review Oneway sensitivity analyses were performed to estimate threshold values for key parameters at which adding MRI would become the optimal imaging strategy over standard assessment Preoperative MRI resulted in 1777 QALYs compared to 1786 QALYs with standard assessment a decrease of 009 QALYs or 34 days In sensitivity analyses standard assessment was associated with better patient outcomes than preoperative breast MRI across all plausible probabilities for mastectomy local recurrence and health utilities For routine preoperative breast MRI to become the optimal strategy the conversion rate to mastectomy after preoperative MRI would need to be 1  versus the range of 36–33  reported in the literature Routine preoperative breast MRI appears to confer no advantage over the standard diagnostic evaluations for earlystage breast cancer and may lead to worse patient outcomes

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