From the Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Republic of Korea (A.Y., N.C., W.K.M.); Department of Radiology, Seoul National College of Medicine, Seoul, Republic of Korea (N.C., W.K.M.); Institute of Radiation Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea (N.C., W.K.M.); Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea (K.S.Y.); and Department of Surgery, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea (W.H., D.Y.N.).
Radiology. 2015 Sep;276(3):695-705. doi: 10.1148/radiol.2015142101. Epub 2015 Apr 27.
To compare breast cancer disease-free survival (DFS) outcomes of patients with newly diagnosed breast cancer without and with preoperative magnetic resonance (MR) imaging. MATERIALS AND METHODS This study was approved by an institutional review board, and informed consent was waived. From 2004 to 2009 (unilateral MR imaging from 2004 to 2006 vs bilateral MR imaging from 2007 to 2009), patients with breast cancer without preoperative MR imaging (no MR imaging group) were matched with those with preoperative MR imaging (MR imaging group) according to age, histologic grade, nuclear grade, tumor size, nodal status, stage, hormone receptor status, Ki-67 status, molecular subtype, and lymphovascular invasion. Survival analysis was performed by using Kaplan-Meier estimates. A marginal model was used to evaluate the effect of preoperative MR imaging on DFS.
A total of 371 patient pairs from the unilateral imaging period and 97 patient pairs from the bilateral imaging period were matched. During the unilateral imaging period, the MR imaging group had better local-regional recurrence DFS (hazard ratio [HR], 0.33; 95% confidence interval [CI]: 0.12, 0.91; P = .032) than did the no MR imaging group; however, no difference was found for contralateral breast (P = .440) or distant recurrence (P = .515) DFS. During the bilateral imaging period, the MR imaging group had better contralateral breast cancer DFS (HR, 0.03; 95% CI: 0.04, 0.21; P < .001) than the no MR imaging group; however, no difference was found for local-regional (P = .180) or distant recurrence (P = .178) DFS.
Preoperative bilateral breast MR imaging for staging of breast cancer was associated with a reduced risk of contralateral breast recurrence; however, no observed reduction in risk of local-regional or distant recurrence was shown.
比较新诊断乳腺癌患者有无术前磁共振成像（MR）的乳腺癌无病生存（DFS）结果。
本研究经机构审查委员会批准，并豁免了知情同意。2004 年至 2009 年（单侧 MR 成像 2004 年至 2006 年，双侧 MR 成像 2007 年至 2009 年），根据年龄、组织学分级、核分级、肿瘤大小、淋巴结状态、分期、激素受体状态、Ki-67 状态、分子亚型和脉管侵犯，将无术前 MR 成像（无 MR 成像组）的乳腺癌患者与有术前 MR 成像（MR 成像组）的患者进行匹配。采用 Kaplan-Meier 估计进行生存分析。采用边缘模型评估术前 MR 成像对 DFS 的影响。
单侧成像期共匹配了 371 对患者，双侧成像期匹配了 97 对患者。在单侧成像期，MR 成像组局部区域复发 DFS 更好（风险比[HR]，0.33；95%置信区间[CI]：0.12，0.91；P=0.032），但对对侧乳房（P=0.440）或远处复发（P=0.515）DFS 无差异。在双侧成像期，MR 成像组对侧乳腺癌 DFS 更好（HR，0.03；95%CI：0.04，0.21；P<0.001），但局部区域（P=0.180）或远处复发（P=0.178）DFS 无差异。
术前双侧乳腺 MR 成像用于乳腺癌分期与降低对侧乳腺癌复发风险相关；然而，未观察到局部区域或远处复发风险降低。
