Title

Are we choosing wisely? Drivers of preoperative MRI use in breast cancer patients.

Document Type

Article

Publication Date

10-23-2021

Publication Title

American Journal of Surgery

Abstract

INTRODUCTION: Factors contributing to the use of preoperative MRI remain poorly understood.

METHODS: Data from a randomized controlled trial of stage 0-3 breast cancer patients undergoing breast conserving surgery between 2016 and 2018 were analyzed.

RESULTS: Of the 396 patients in this trial, 32.6% had a preoperative MRI. Patient age, race, ethnicity, tumor histology, and use of neoadjuvant therapy were significant predictors of MRI use. On multivariate analysis, younger patients with invasive lobular tumors were more likely to have a preoperative MRI. Rates also varied significantly by individual surgeon (p < 0.001); in particular, female surgeons (39.9% vs. 24.0% for male surgeons, p = 0.001) and those in community practice (58.9% vs. 14.2% for academic, p < 0.001) were more likely to order preoperative MRI. Rates declined over the two years of the study, particularly among female surgeons.

CONCLUSIONS: Preoperative MRI varies with patient age and tumor histology; however, there remains variability by individual surgeon.

Volume

Online ahead of print

First Page

S0002-9610(21)00620-6

DOI

10.1016/j.amjsurg.2021.10.028

ISSN

1879-1883

PubMed ID

34706816

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