Surgical attitudes toward preoperative breast magnetic resonance imaging in women with early-stage breast cancer

Curr Oncol. 2019 Apr;26(2):e194-e201. doi: 10.3747/co.26.4227. Epub 2019 Apr 1.

Abstract

Background: Preoperative breast magnetic resonance imaging (mri) is commonly requested by surgeons in the initial workup of women with breast cancer; however, its use is controversial. We performed a survey of breast cancer surgeons across Canada to investigate current knowledge about, attitudes to, and self-reported use of preoperative breast mri in a publicly funded health care system in light of the limited evidence to support it.

Methods: All identified general surgeons in Canada were mailed a survey instrument designed to probe current practice and knowledge of published trials.

Results: Of 403 responding surgeons, 233 (58%) indicated that they performed breast cancer surgery. Of those 233, 218 (94%) had access to breast mri and completed the entire survey. Overall, 54.6% of responding surgeons felt that breast mri was useful in surgical planning, and more than half (58.3%) indicated that their frequency of use was likely to increase over the next 5 years. Surgeons found preoperative mri most useful in detecting mammographically occult disease (71.5% of respondents) and in planning for breast-conserving surgery (57.3%). The main limitations reported were timely access to mri (51%) and false positives (36.7%). Responses suggest a knowledge gap in awareness of published trials in breast mri.

Conclusions: Our study found that, in early-stage breast cancer, self-reported use of mri by breast cancer surgeons in Canada varied widely. Reported indications did not align with published data, and significant gaps in self-reported knowledge of the data were evident. Our results would support the development and dissemination of guidelines to optimize use of mri.

Keywords: Preoperative assessment; breast cancer; magnetic resonance imaging.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Attitude of Health Personnel
  • Breast Neoplasms / diagnostic imaging*
  • Canada
  • Female
  • Humans
  • Magnetic Resonance Imaging*
  • Oncologists*
  • Practice Patterns, Physicians'*
  • Preoperative Period*
  • Surgeons*
  • Surveys and Questionnaires

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