Evidence mapPaperPMID 37999727Full record

Observational studyEuropean radiology2024

Preoperative breast MRI positively impacts surgical outcomes of needle biopsy-diagnosed pure DCIS: a patient-matched analysis 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

Abstract readObservational Study
In one paragraph

Observational study in European radiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
field-weighted citation impact
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

7 citing papers in PubMed.

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

Corrections and comments

5 · Who and what money

Authors and funding

45 authors.

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 HelbichDivision of General and Paediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, 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 ClauserDivision of General and Paediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, 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 Aksoy OzcanDepartment of Radiology, Acıbadem Atasehir Hospital, Istanbul, Turkey.
Federica PediconiDepartment of Radiological, Oncological and Pathological Sciences, Università degli Studi di Roma "La Sapienza", Rome, Italy.
Katja PinkerDivision of General and Paediatric Radiology, Department of Biomedical Imaging and Image-Guided Therapy, 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.
Sila Ö UlusDepartment of Radiology, Acıbadem Atasehir Hospital, Istanbul, Turkey.
Mireille Van GoethemGynecological Oncology Unit, Department of Obstetrics and Gynecology, Department of Radiology, Multidisciplinary Breast Clinic, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium.
Jeroen VeltmanMaatschap Radiologie Oost-Nederland, Oldenzaal, The Netherlands.
Stefanie WeigelClinic for 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

Funding

The Patient-Reported Outcomes, Community-Engagement and Language (PRO-CEL) CoreP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · 1985 to 2025
$88.4M
NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

objectivesTo investigate the influence of preoperative breast MRI on mastectomy and reoperation rates in patients with pure ductal carcinoma in situ (DCIS).

methodsThe MIPA observational study database (7245 patients) was searched for patients aged 18-80 years with pure unilateral DCIS diagnosed at core needle or vacuum-assisted biopsy (CNB/VAB) and planned for primary surgery. Patients who underwent preoperative MRI (MRI group) were matched (1:1) to those who did not receive MRI (noMRI group) according to 8 confounding covariates that drive referral to MRI (age; hormonal status; familial risk; posterior-to-nipple diameter; BI-RADS category; lesion diameter; lesion presentation; surgical planning at conventional imaging). Surgical outcomes were compared between the matched groups with nonparametric statistics after calculating odds ratios (ORs).

resultsOf 1005 women with pure unilateral DCIS at CNB/VAB (507 MRI group, 498 noMRI group), 309 remained in each group after matching. First-line mastectomy rate in the MRI group was 20.1% (62/309 patients, OR 2.03) compared to 11.0% in the noMRI group (34/309 patients, p = 0.003). The reoperation rate was 10.0% in the MRI group (31/309, OR for reoperation 0.40) and 22.0% in the noMRI group (68/309, p < 0.001), with a 2.53 OR of avoiding reoperation in the MRI group. The overall mastectomy rate was 23.3% in the MRI group (72/309, OR 1.40) and 17.8% in the noMRI group (55/309, p = 0.111).

conclusionsCompared to those going directly to surgery, patients with pure DCIS at CNB/VAB who underwent preoperative MRI had a higher OR for first-line mastectomy but a substantially lower OR for reoperation. CLINICAL RELEVANCE STATEMENT: When confounding factors behind MRI referral are accounted for in the comparison of patients with CNB/VAB-diagnosed pure unilateral DCIS, preoperative MRI yields a reduction of reoperations that is more than twice as high as the increase in overall mastectomies. KEY POINTS: • Confounding factors cause imbalance when investigating the influence of preoperative MRI on surgical outcomes of pure DCIS. • When patient matching is applied to women with pure unilateral DCIS, reoperation rates are significantly reduced in women who underwent preoperative MRI. • The reduction of reoperations brought about by preoperative MRI is more than double the increase in overall mastectomies.

Indexed as

Breast NeoplasmsCarcinoma, Intraductal, NoninfiltratingMagnetic Resonance ImagingMastectomyReoperationAdolescentAdultAgedAged, 80 and overBiopsy, NeedleBreastFemaleHumansMiddle AgedPreoperative CareTreatment OutcomeBreast neoplasms (biopsy, needle)Carcinoma (intraductal, noninfiltrating)Magnetic resonance imagingMastectomyReoperation

Identifiers

PMID37999727
PMCPMC11166778

What Socratic holds

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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 Socratic graph.