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MRIs May Spur Unneeded Mastectomies in Older Women With Breast Cancer

More aggressive surgery not always backed by evidence, study authors say

WEDNESDAY, Aug. 14 (HealthDay News) -- The growing use of MRI in breast cancer patients may be leading to unnecessary breast removal in older women, according to a large new study.

Researchers examined the use of breast MRI and surgery in more than 72,000 American women aged 67 to 94 who were diagnosed with breast cancer between 2000 and 2009. During that time, the use of MRI before surgery increased from 1 percent to 25 percent of patients.

Women who received an MRI were more likely to have more aggressive surgery. Among women who underwent breast removal (mastectomy), 12.5 percent of those who had an MRI had both breasts removed, compared with about 4 percent of those who did not have an MRI.

The researchers also found that women who had MRI were more likely to have surgery to remove both breasts when cancer was only found in one breast, a procedure called contralateral prophylactic mastectomy. Among mastectomy patients, nearly 7 percent of those who had an MRI underwent contralateral prophylactic mastectomy, compared with about 2 percent of those who did not have an MRI.

The findings, published in the journal Breast Cancer Research and Treatment, are concerning because the long-term benefits of having both breasts removed are unclear, said lead author Dr. Cary Gross, an associate professor of internal medicine at Yale School of Medicine and director of the Cancer Outcomes, Public Policy and Effectiveness Research Center at Yale Cancer Center.

"Patient concern about recurrence and survival must be balanced with the increased risk for complications associated with more aggressive cancer surgery, particularly when there is no proven benefit of the more aggressive option," Gross said in a Yale news release.

"There has been no randomized controlled clinical trial demonstrating improved outcomes for women who undergo preoperative breast MRI at any age," study first author Dr. Brigid Killelea, an assistant professor of surgery at Yale School of Medicine, said in the news release. "Breast-conserving therapy, when feasible, remains the preferred approach for women with early-stage breast cancer."

More information

The American Cancer Society has more about surgery for cancer.


SOURCE: Yale University, news release, Aug. 14, 2013

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