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UK Researchers with the COMICE randomized trial have reported that preoperative magnetic resonance imaging ( MRI ) does not affect reoperation rates in women with early-stage breast cancer.

The study appeared in the February 13, 2010 issue of the Lancet.

Preoperative MRI is increasingly being used in women with early-stage breast cancer who are undergoing breast-conserving surgery (lumpectomy) in order to detect additional areas of disease that may need to be removed but weren’t detectable with conventional imaging. The use of preoperative MRI is based on the assumption that it improves surgical planning, reduces follow-up surgery, and reduces the risk of local recurrence.

However, researchers from the University of Sydney, Australia, and the University of Michigan Comprehensive Cancer Center have reported that preoperative MRI in early breast cancer leads to more extensive surgery without evidence of improvement in surgical outcomes or long-term prognosis. This conclusion was based on more than 20 studies evaluating the impact of MRI on detection and surgical treatment in women with early-stage breast cancer.

These researchers concluded that more research is needed - in the form of randomized, controlled trials - to evaluate preoperative MRI in breast cancer patients. In the meantime they conclude that MRI causes false-positives and unnecessary surgery and does not appear to reduce re-excision rates. They assert that preoperative MRI may actually do more harm than good.

The current study randomly allocated 1,623 women with early-stage breast cancer to receive conventional preoperative assessment prior to local excision or conventional preoperative assessment plus MRI.
The reoperation rate was 19% for both the MRI and non-MRI arms of this study

Their findings are of benefit to the NHS (National Health Service) because they show that MRI might be unnecessary in this population of patients to reduce repeat operation rates, and could assist in improved NHS services.

Source: The Lancet

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