"Although MRI was associated with a higher mastectomy rate, we cannot assume it is a cause-and-effect relationship," says co-author Amy Degnim, M.D., a breast surgeon at Mayo Clinic and an assistant professor of surgery. "More investigation at an individual level is needed to understand better how MRI may impact personal choices for breast cancer surgery."
Dr. Goetz says that, while MRI was associated with an increased mastectomy rate, the mastectomy rates also increased in women who did not undergo MRI, suggesting other factors are playing an important role in the decision-making process of patients and physicians.
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"In the past 10 years, we have observed numerous changes in the preoperative management of patients with breast cancer," says Dr. Goetz. "In addition to new imaging modalities such as MRI, more women are familiar with the role of genetics as a risk factor for breast cancer, and some of our patients are undergoing testing. Additionally, there has been improved access to better breast reconstruction methods."
Lumpectomy plus radiation therapy (known as breast conserving therapy [BCT]) has been the standard of care for most women with early-stage disease since 1990. That year, the National Institutes of Health issued a report stating that BCT was as effective as mastectomy for overall survival for most women with stage I or stage II breast cancer. Shortly thereafter, mastectomy rates began to decline. But the data from Mayo Clinic suggest that this trend may be in reversal.
Other Mayo Clinic researchers involved with this study included Tanya Hoskin; Judy Boughey, M.D.; Clive Grant, M.D.; Kathy Brandt, M.D.; Charles Loprinzi, M.D.; and Sandhya Pruthi, M.D. This research was supported in part by the Paul Calabresi Program in Clinical-Translational Research at Mayo Clinic and the Mayo Clinic Breast Cancer Specialized Program of Research Excellence. Visit mayoresearch.mayo.edu/mayo/research/womens_cancer for more information about research into women's cancers or breast cancer at Mayo Clinic:
ASCO abstract number: 509
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