Clinical findings and outcomes of MRI staging of breast cancer in a diverse population

Akshara Raghavendra, Julie Wecsler, Lingyun Ji, Pulin Sheth, Charite Ricker, Terry Church, Richard Sposto, Julie Lang, Stephen Sener, Linda Larsen, Debu Tripathy

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

Background: The performance of magnetic resonance imaging (MRI), the effect of patient factors, and resulting surgical management in underserved and ethnically diverse breast cancer (BC) patient populations have been understudied. Methods: We retrospectively analyzed the data of 1116 consecutive patients who were newly diagnosed with in situ or invasive BC with preoperative staging MRI. Non-index lesions (NILs) were defined as abnormal MRI findings with BI-RADS score of 4 or 5 in breast or axillary nodes not previously detected by conventional imaging. Occult cancers (OCs) were NILs found to be malignant by biopsy or surgery. Logistic regression was used to examine associations between probabilities of NILs or OCs and patient characteristics. Results: Staging MRI detected NILs and OCs in 24% and 7.5% of patients, respectively. Of 1116 patients, 271 (24%) had 327 NILs, and 84 (7.5%) had 87 OCs. Follow-up information was available for 306 NILs. Ipsilateral breast NILs (n = 124) were seen in 115 patients (10.3%), with OCs (n = 51) seen in 48 patients (4.4%). Contralateral breast NILs (n = 134) were seen in 118 (10.6%) patients, with OCs (n = 20) seen in 20 patients (1.8%). Laterality (p < 0.001) and disease stage (p = 0.018) were associated with probability of OC. Patients without BRCA mutations had a significantly higher probability of having NILs (p = 0.003) but not OCs. Conclusions: Our study provides useful estimates of the rates of NILs and OCs anticipated in a younger, uninsured, ethnically diverse population. Prospective trials and larger pooled retrospective analyses are needed to define the long-term impacts of MRI staging after a BC diagnosis.

Original languageEnglish (US)
Pages (from-to)315-324
Number of pages10
JournalBreast Cancer Research and Treatment
Volume174
Issue number2
DOIs
StatePublished - Apr 15 2019

Keywords

  • BRCA
  • Body mass index
  • Breast density
  • Magnetic resonance imaging
  • Neoadjuvant therapy
  • Non-index lesions
  • Occult cancer
  • Risk factors
  • Screening
  • Underserved populations

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

MD Anderson CCSG core facilities

  • Clinical Trials Office

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