The addition of magnetic resonance imaging (MRI) to the initial, pre-operative assessment of women with small breast cancers does not reduce the re-operation rate for incompletely excised tumour, suggests research published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme.
The number of women having a repeat operation or mastectomy, following initial lumpectomy, for incompletely excised breast cancer rose from 14% to 17% in 2006/7. This is a considerable additional burden to both the patient and the NHS. To help reduce this rate the NHS is considering whether to recommend the addition of MRI to mammography for the assessment of breast cancer. Professor Lindsay Turnbull of the University of Hull and her team have completed the largest clinical trial of its kind into this aspect of MRI. They assessed whether the addition of MRI to the current method of patient evaluation by triple assessment (clinical examination, imaging (mammography and ultrasound) and biopsy) would aid breast tumour localisation and reduce the re-operation rate in women with primary tumours. They also evaluated the cost to the NHS of adding MRI to the assessment process. Of 1623 women recruited to take part in the trial, 816 were randomised to receive MRI and 807 to receive no MRI. The results showed no differences in the re-operation rate between these two groups. The reoperation rate was 18.75% for the MRI patients and 19.33% for the “no” MRI patient group. The economic analysis indicated that the addition of MR imaging to the triple assessment would cost more but offered few or no benefits in terms of clinical outcome or quality of life.
