Evidence map›Paper›PMID 37138190›Full record

Observational studyEuropean radiology2023

Screening and diagnostic breast MRI: how do they impact surgical treatment? Insights from the MIPA study.

Andrea Cozzi, Giovanni Di Leo, Nehmat Houssami, Fiona J Gilbert, Thomas H Helbich, Marina Álvarez Benito, Corinne Balleyguier, Massimo Bazzocchi, Peter Bult, Massimo Calabrese and 35 more

Open access · hybridAbstract readObservational Study
In one paragraph

Observational study in European radiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.5field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Review
  3. Observational
  4. Article
  5. Article
  6. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

45 authors at 20 institutions in 13 countries.

Andrea CozziUnit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097, San Donato Milanese, Italy.
Giovanni Di LeoUnit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097, San Donato Milanese, Italy.
Nehmat HoussamiThe Daffodil Centre, Faculty of Medicine and Health, The University of Sydney (Joint Venture with Cancer Council NSW), Sydney, Australia.
Fiona J GilbertDepartment of Radiology, School of Clinical Medicine, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
Thomas H HelbichDepartment of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Structural Preclinical Imaging, Medical University of Vienna, Vienna, Austria.
Marina Álvarez BenitoDepartment of Radiology, Hospital Universitario Reina Sofía, Córdoba, Spain.
Corinne BalleyguierDepartment of Radiology, Institut Gustave Roussy, Villejuif, France.
Massimo BazzocchiInstitute of Radiology, Department of Medicine, Ospedale Universitario S. Maria della Misericordia, Università degli Studi di Udine, Udine, Italy.
Peter BultDepartment of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands.
Massimo CalabreseUnit of Oncological and Breast Radiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
Julia Camps HerreroDepartment of Radiology, Hospital Universitario de La Ribera, Alzira, Spain.
Francesco CartiaUnit of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Enrico CassanoBreast Imaging Division, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Paola ClauserDepartment of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Structural Preclinical Imaging, Medical University of Vienna, Vienna, Austria.
Marcos F de Lima DocemaDepartment of Radiology, Hospital Sírio Libanês, São Paulo, Brazil.
Catherine DeprettoUnit of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Valeria DominelliBreast Imaging Division, IEO, European Institute of Oncology IRCCS, Milan, Italy.
Gábor ForraiDepartment of Radiology, MHEK Teaching Hospital, Semmelweis University, Budapest, Hungary.
Rossano GiromettiInstitute of Radiology, Department of Medicine, Ospedale Universitario S. Maria della Misericordia, Università degli Studi di Udine, Udine, Italy.
Steven E HarmsBreast Center of Northwest Arkansas, Fayetteville, AR, USA.
Sarah HilborneDepartment of Radiology, School of Clinical Medicine, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
Raffaele IenziDepartment of Radiology, Di.Bi.MED, Policlinico Universitario Paolo Giaccone, Università degli Studi di Palermo, Palermo, Italy.
Marc B I LobbesDepartment of Radiology and Nuclear Medicine, Maastricht University Medical Center, Maastricht, The Netherlands.
Claudio LosioDepartment of Breast Radiology, IRCCS Ospedale San Raffaele, Milan, Italy.
Ritse M MannDepartment of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Stefania MontemezziDepartment of Radiology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy.
Inge-Marie ObdeijnDepartment of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
Umit A OzcanUnit of Radiology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey.
Federica PediconiDepartment of Radiological, Oncological and Pathological Sciences, Università degli Studi di Roma "La Sapienza", Rome, Italy.
Katja PinkerDepartment of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Structural Preclinical Imaging, Medical University of Vienna, Vienna, Austria.
Heike PreibschDepartment of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Tübingen, Germany.
José L Raya PovedanoDepartment of Radiology, Hospital Universitario Reina Sofía, Córdoba, Spain.
Carolina Rossi SaccarelliDepartment of Radiology, Hospital Sírio Libanês, São Paulo, Brazil.
Daniela SacchettoKiwifarm S.r.l, La Morra, Italy.
Gianfranco P ScaperrottaUnit of Breast Imaging, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Margrethe SchloozDepartment of Surgery, Radboud University Medical Center, Nijmegen, The Netherlands.
Botond K SzabóDepartment of Radiology, Barking Havering and Redbridge University Hospitals NHS Trust, London, UK.
Donna B TaylorMedical School, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, Australia.
Özden S UlusUnit of Radiology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, İstanbul, Turkey.
Mireille Van GoethemGynecological Oncology Unit, Department of Obstetrics and Gynecology, Department of Radiology, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Antwerpen, Belgium.
Jeroen VeltmanMaatschap Radiologie Oost-Nederland, Oldenzaal, The Netherlands.
Stefanie WeigelInstitute of Clinical Radiology and Reference Center for Mammography, University of Münster, Münster, Germany.
Evelyn WenkelDepartment of Radiology, University Hospital of Erlangen, Erlangen, Germany.
Chiara ZuianiInstitute of Radiology, Department of Medicine, Ospedale Universitario S. Maria della Misericordia, Università degli Studi di Udine, Udine, Italy.
Francesco SardanelliUnit of Radiology, IRCCS Policlinico San Donato, Via Rodolfo Morandi 30, 20097, San Donato Milanese, Italy. francesco.sardanelli@unimi.it.ORCID http://orcid.org/0000-0001-6545-9427
Fondazione IRCCS Istituto Nazionale dei Tumori · ITRadboud University Nijmegen · NLUniversity of Udine · ITEuropean Institute of Oncology · ITHospital Sírio-Libanês · BRHospital Universitario Reina Sofía · ESIRCCS Policlinico San Donato · ITKent Hastanesi · TRMedical University of Vienna · ATUniversity of Cambridge · GBAzienda Ospedaliera Universitaria Integrata Verona · ITAzienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo · ITBarking, Havering And Redbridge University Hospitals NHS Trust · GBCentre National de la Recherche Scientifique · FRErasmus MC · NLHospital de La Ribera · ESIRCCS Ospedale San Raffaele · ITMaastricht University · NLMemorial Sloan Kettering Cancer Center · USOntwikkelingsmaatschappij Oost Nederland · NL

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI SELWYN M VICKERS · 1985 to 2026
$347.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

objectivesTo report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/nonreferral and other covariates in driving surgical outcomes.

methodsThe MIPA observational study enrolled women aged 18-80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis.

resultsA total of 5828 patients entered analysis, 2763 (47.4%) did not undergo MRI (noMRI subgroup) and 3065 underwent MRI (52.6%); of the latter, 2441/3065 (79.7%) underwent MRI with preoperative intent (P-MRI subgroup), 510/3065 (16.6%) D-MRI, and 114/3065 S-MRI (3.7%). The reoperation rate was 10.5% for S-MRI, 8.2% for D-MRI, and 8.5% for P-MRI, while it was 11.7% for noMRI (p ≤ 0.023 for comparisons with D-MRI and P-MRI). The overall mastectomy rate (first-line mastectomy plus conversions from conserving surgery to mastectomy) was 39.5% for S-MRI, 36.2% for P-MRI, 24.1% for D-MRI, and 18.0% for noMRI. At multivariable analysis, using noMRI as reference, the odds ratios for overall mastectomy were 2.4 (p < 0.001) for S-MRI, 1.0 (p = 0.957) for D-MRI, and 1.9 (p < 0.001) for P-MRI.

conclusionsPatients from the D-MRI subgroup had the lowest overall mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). This analysis offers an insight into how the initial indication for MRI affects the subsequent surgical treatment of breast cancer. KEY POINTS: • Of 3065 breast MRI examinations, 79.7% were performed with preoperative intent (P-MRI), 16.6% were diagnostic (D-MRI), and 3.7% were screening (S-MRI) examinations. • The D-MRI subgroup had the lowest mastectomy rate (24.1%) among MRI subgroups and the lowest reoperation rate (8.2%) together with P-MRI (8.5%). • The S-MRI subgroup had the highest mastectomy rate (39.5%) which aligns with higher-than-average risk in this subgroup, with a reoperation rate (10.5%) not significantly different to that of all other subgroups.

Indexed as

Breast NeoplasmsBreastFemaleHumansMagnetic Resonance ImagingMastectomyMastectomy, SegmentalPreoperative CareBreast-conserving surgeryBreast neoplasmsMagnetic resonance imagingMastectomyReoperation

Identifiers

PMID37138190
PMCPMC10415233
OpenAlexW4367856520

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.