Eight-fold increase during 10-year period; MRI use linked to more ancillary investigations
THURSDAY, Sept. 24, 2015 (HealthDay News) — From 2003 to 2102 there was a significant increase in preoperative breast magnetic resonance imaging (MRI) use in women with breast cancer, according to a study published online Sept. 24 in JAMA Oncology.
Angel Arnaout, M.D., from Ottawa Hospital in Canada, and colleagues describe patterns of preoperative breast MRI utilization in a health care system with universal insurance. Data were included from administrative health care databases in Ontario, Canada, in a retrospective cohort study. The cohort included 53,015 patients with primary operable breast cancer who were treated from 2003 to 2012.
The researchers found that 14.8 percent of patients underwent a preoperative MRI. There was an eight-fold increase in MRI use across all stages during the 10-year study period (from 3 to 24 percent; P < 0.001 for trend). Younger age, higher socioeconomic status, higher Charlson comorbidity score, surgery performed in teaching hospital, and fewer years of surgeon experience correlated with MRI use. Preoperative breast MRI correlated with increased likelihood of post-diagnosis breast imaging, post-diagnosis breast biopsies, and post-diagnosis imaging to assess for distant metastases (odds ratios, 2.09, 1.74, and 1.51, respectively), as well as with mastectomy, contralateral prophylactic mastectomy, and a greater than 30-day wait to surgery (odds ratios, 1.73, 1.48 and 2.52, respectively), in multivariate analyses.
“Preoperative breast MRI use has increased substantially in routine clinical practice and is associated with a significant increase in ancillary investigations, wait time to surgery, mastectomies, and contralateral prophylactic mastectomies,” the authors write.
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