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The Effect of Increase Use of Breast MRI in the Diagnosis of Breast Cancer and the Effect on Mastectomy Rate
*Jennifer Williams
Brown/RIH, Providence, RI

Objective(s): We hypothesized that pre-operative breast MRI finding have increased mastectomy rates in our patient population.
Design: We preformed a signal center, retrospective chart review of all newly diagnosis breast cancer patients from 1/2005 - 5/2008. Five hundred and twenty five records were reviewed effective sample size of 476) and divided into three groups based on time of diagnosis.
Setting: Rhode Island Hospital, Brown University
Patients: Five hundred and twenty five records were reviewed
Interventions: We then collected demographic, radiographic, pathologic, genetic and staging data on each patient. The reason for breast conservation vs. mastectomy was also recorded. Statistical analysis was complete using the Pearson chi-square and Fisher’s exact tests.
Main Outcome Measure(s): Rate of pre-operative MRI, mastectomy, and reason for mastectomy
Results: The use of breast MRI has markedly increase over the time period studied (15.8% of the pre-MRI and 70% of the post-MRI group). The unilateral mastectomy rates between both groups were similar (pre-MRI group: 21.5%, post-MRI group: 22.4%) however there was an increase in bilateral mastectomy (pre-MRI group: 3.1% and post-MRI group: 8.5%). The reason for mastectomy also differed between the two groups with surgeons’ recommendation after MRI accounting for only 6% of patients in the pre-MRI group and 33% of patients in the post MRI group.
Conclusions: The use of breast MRI in the initial workup of breast cancer patients has markedly increased at our institution since 2007. Unilateral mastectomy rates were stable between groups with an increase in bilateral mastectomy rates note in the post-MRI group. The reason for mastectomy has change with the increased use of breast MRI.

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