TY - JOUR
T1 - Solving the preoperative breast MRI conundrum
T2 - design and protocol of the MIPA study
AU - Sardanelli, Francesco
AU - Trimboli, Rubina M.
AU - Houssami, Nehmat
AU - Gilbert, Fiona J.
AU - Helbich, Thomas H.
AU - Alvarez Benito, Marina
AU - Balleyguier, Corinne
AU - Bazzocchi, Massimo
AU - Bult, Peter
AU - Calabrese, Massimo
AU - Camps Herrero, Julia
AU - Cartia, Francesco
AU - Cassano, Enrico
AU - Clauser, Paola
AU - de Andrade, Danubia A.
AU - de Lima Docema, Marcos F.
AU - Depretto, Catherine
AU - Forrai, Gabor
AU - Girometti, Rossano
AU - Harms, Steven E.
AU - Hilborne, Sarah
AU - Ienzi, Raffaele
AU - Lobbes, Marc B.I.
AU - Losio, Claudio
AU - Mann, Ritse M.
AU - Montemezzi, Stefania
AU - Obdeijn, Inge Marie
AU - Ozcan, Umit Aksoy
AU - Pediconi, Federica
AU - Preibsch, Heike
AU - Raya-Povedano, José L.
AU - Sacchetto, Daniela
AU - Scaperrotta, Gianfranco P.
AU - Schlooz, Margrethe
AU - Szabo, Botond K.
AU - Ulus, Ozden S.
AU - Taylor, Donna B.
AU - Van Goethem, Mireille
AU - Veltman, Jeroen
AU - Weigel, Stefanie
AU - Wenkel, Evelyn
AU - Zuiani, Chiara
AU - Di Leo, Giovanni
N1 - Publisher Copyright:
© 2020, European Society of Radiology.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - Abstract: Despite its high diagnostic performance, the use of breast MRI in the preoperative setting is controversial. It has the potential for personalized surgical management in breast cancer patients, but two of three randomized controlled trials did not show results in favor of its introduction for assessing the disease extent before surgery. Meta-analyses showed a higher mastectomy rate in women undergoing preoperative MRI compared to those who do not. Nevertheless, preoperative breast MRI is increasingly used and a survey from the American Society of Breast Surgeons showed that 41% of respondents ask for it in daily practice. In this context, a large-scale observational multicenter international prospective analysis (MIPA study) was proposed under the guidance of the European Network for the Assessment of Imaging in Medicine (EuroAIM). The aims were (1) to prospectively and systematically collect data on consecutive women with a newly diagnosed breast cancer, not candidates for neoadjuvant therapy, who are offered or not offered breast MRI before surgery according to local practice; (2) to compare these two groups in terms of surgical and clinical endpoints, adjusting for covariates. The underlying hypotheses are that MRI does not cause additional mastectomies compared to conventional imaging, while reducing the reoperation rate in all or in subgroups of patients. Ninety-six centers applied to a web-based call; 36 were initially selected based on volume and quality standards; 27 were active for enrollment. On November 2018, the target of 7000 enrolled patients was reached. The MIPA study is presently at the analytic phase. Key Points • Breast MRI has a high diagnostic performance but its utility in the preoperative setting is controversial. • A large-scale observational multicenter prospective study was launched to compare women receiving with those not receiving preoperative MRI. • Twenty-seven centers enrolled more than 7000 patients. The study is presently at the analytic phase.
AB - Abstract: Despite its high diagnostic performance, the use of breast MRI in the preoperative setting is controversial. It has the potential for personalized surgical management in breast cancer patients, but two of three randomized controlled trials did not show results in favor of its introduction for assessing the disease extent before surgery. Meta-analyses showed a higher mastectomy rate in women undergoing preoperative MRI compared to those who do not. Nevertheless, preoperative breast MRI is increasingly used and a survey from the American Society of Breast Surgeons showed that 41% of respondents ask for it in daily practice. In this context, a large-scale observational multicenter international prospective analysis (MIPA study) was proposed under the guidance of the European Network for the Assessment of Imaging in Medicine (EuroAIM). The aims were (1) to prospectively and systematically collect data on consecutive women with a newly diagnosed breast cancer, not candidates for neoadjuvant therapy, who are offered or not offered breast MRI before surgery according to local practice; (2) to compare these two groups in terms of surgical and clinical endpoints, adjusting for covariates. The underlying hypotheses are that MRI does not cause additional mastectomies compared to conventional imaging, while reducing the reoperation rate in all or in subgroups of patients. Ninety-six centers applied to a web-based call; 36 were initially selected based on volume and quality standards; 27 were active for enrollment. On November 2018, the target of 7000 enrolled patients was reached. The MIPA study is presently at the analytic phase. Key Points • Breast MRI has a high diagnostic performance but its utility in the preoperative setting is controversial. • A large-scale observational multicenter prospective study was launched to compare women receiving with those not receiving preoperative MRI. • Twenty-seven centers enrolled more than 7000 patients. The study is presently at the analytic phase.
KW - Breast neoplasms
KW - Breast-conserving surgery
KW - Magnetic resonance imaging
KW - Mastectomy
KW - Prospective studies
UR - http://www.scopus.com/inward/record.url?scp=85085153457&partnerID=8YFLogxK
U2 - 10.1007/s00330-020-06824-7
DO - 10.1007/s00330-020-06824-7
M3 - Article
C2 - 32377813
AN - SCOPUS:85085153457
SN - 0938-7994
VL - 30
SP - 5427
EP - 5436
JO - European Radiology
JF - European Radiology
IS - 10
ER -