Preoperative breast magnetic resonance imaging in patients with ductal carcinoma in situ: a systematic review for the European Commission Initiative on Breast Cancer (ECIBC)

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  • dc.contributor.author Canelo Aybar, Carlos
  • dc.contributor.author Taype Rondan, Alvaro
  • dc.contributor.author Zafra Tanaka, Jessica Hanae
  • dc.contributor.author Rigau, David
  • dc.contributor.author Graewingholt, Axel
  • dc.contributor.author Lebeau, Annette
  • dc.contributor.author Pérez Gómez, Elsa
  • dc.contributor.author Rossi, Paolo Giorgi
  • dc.contributor.author Langedam, Miranda
  • dc.contributor.author Posso, Margarita
  • dc.contributor.author Parmelli, Elena
  • dc.contributor.author Saz Parkinson, Zuleika
  • dc.contributor.author Alonso Coello, Pablo
  • dc.date.accessioned 2021-09-16T06:01:25Z
  • dc.date.available 2021-09-16T06:01:25Z
  • dc.date.issued 2021
  • dc.description.abstract Objective: To evaluate the impact of preoperative MRI in the management of Ductal carcinoma in situ (DCIS). Methods: We searched the PubMed, EMBASE and Cochrane Library databases to identify randomised clinical trials (RCTs) or cohort studies assessing the impact of preoperative breast MRI in surgical outcomes, treatment change or loco-regional recurrence. We provided pooled estimates for odds ratios (OR), relative risks (RR) and proportions and assessed the certainty of the evidence using the GRADE approach. Results: We included 3 RCTs and 23 observational cohorts, corresponding to 20,415 patients. For initial breast-conserving surgery (BCS), the RCTs showed that MRI may result in little to no difference (RR 0.95, 95% CI 0.90 to 1.00) (low certainty); observational studies showed that MRI may have no difference in the odds of re-operation after BCS (OR 0.96; 95% CI 0.36 to 2.61) (low certainty); and uncertain evidence from RCTs suggests little to no difference with respect to total mastectomy rate (RR 0.91; 95% CI 0.65 to 1.27) (very low certainty). We also found that MRI may change the initial treatment plans in 17% (95% CI 12 to 24%) of cases, but with little to no effect on locoregional recurrence (aHR = 1.18; 95% CI 0.79 to 1.76) (very low certainty). Conclusion: We found evidence of low to very low certainty which may suggest there is no improvement of surgical outcomes with pre-operative MRI assessment of women with DCIS lesions. There is a need for large rigorously conducted RCTs to evaluate the role of preoperative MRI in this population. Key points: • Evidence of low to very low certainty may suggest there is no improvement in surgical outcomes with pre-operative MRI. • There is a need for large rigorously conducted RCTs evaluating the role of preoperative MRI to improve treatment planning for DCIS.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Canelo-Aybar C, Taype-Rondan A, Zafra-Tanaka JH, Rigau D, Graewingholt A, Lebeau A, Pérez Gómez E, Rossi PG, Langedam M, Posso M, Parmelli E, Saz-Parkinson Z, Alonso-Coello P. Preoperative breast magnetic resonance imaging in patients with ductal carcinoma in situ: a systematic review for the European Commission Initiative on Breast Cancer (ECIBC). Eur Radiol. 2021;31(8):5880-93. DOI: 10.1007/s00330-021-07873-2
  • dc.identifier.doi http://dx.doi.org/10.1007/s00330-021-07873-2
  • dc.identifier.issn 0938-7994
  • dc.identifier.uri http://hdl.handle.net/10230/48460
  • dc.language.iso eng
  • dc.publisher Springer
  • dc.relation.ispartof Eur Radiol. 2021;31(8):5880-93
  • dc.rights © The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by/4.0/
  • dc.subject.keyword Breast cancer
  • dc.subject.keyword Ductal carcinoma in situ
  • dc.subject.keyword Magnetic resonance imaging
  • dc.title Preoperative breast magnetic resonance imaging in patients with ductal carcinoma in situ: a systematic review for the European Commission Initiative on Breast Cancer (ECIBC)
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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