Study Shows Steep Rise in the Use of MRI Scans Before Breast Cancer Surgery

The results of a new study have shown an eightfold rise in the use of Magnetic Resonance Imaging (MRI) scans before breast cancer surgery in the Canadian province of Ontario between 2003 and 2012.

Guidelines on the use of MRI scans before surgery are inconsistent, the study showed, and the increased use of MRI was characteristic of younger, wealthier patients, with a likelihood of additional health problems. The study also found that the use of MRI scans in this context was linked to longer waiting times for surgery and additional testing, and a higher chance of mastectomy, including that of the healthy breast.

The researchers used a large number of healthcare databases in Ontario for the study, and evaluated more than 53,000 women that were diagnosed with breast cancer. The study was published online on September 24, 2015, in the journal JAMA Oncology. The researchers found that only 3% of patients had a preoperative MRI scan in 2003, while in 2012 nearly 24% received an MRI scan. A similar increase was also reported from the US.

MRI scanning is much more expensive than ultrasound, for example, and some of the scans may have been unnecessary. Guidelines for preoperative MRI are and confusing and inconsistent, according to a coauthor of the editorial that accompanied the study, Dr. Constance Lehman, director of breast imaging, Massachusetts General Hospital (Boston, MA, USA).

The study did not show the extent to which the MRI affected clinician’s decisions for further treatment since the medical records used did not indicate whether the results of the MRI scan were positive or negative.

Another coauthor of the study editorial, Dr. Habib Rahbar, University of Washington (Seattle, WA, USA), said, "It is important that we carefully consider how this powerful imaging tool can be used to provide more individualized and targeted therapies to women, rather than not use it altogether."

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Massachusetts General Hospital
University of Washington, Seattle