Spectrum Health General Surgery Residency Program, 100 Michigan Street NE, Suite A501, Grand Rapids, MI, 49503, United States; Michigan State University College of Human Medicine, Department of Surgery, 15 Michigan Street NE, Grand Rapids, MI, 49503, United States.
Spectrum Health General Surgery Residency Program, 100 Michigan Street NE, Suite A501, Grand Rapids, MI, 49503, United States; Michigan State University College of Human Medicine, Department of Surgery, 15 Michigan Street NE, Grand Rapids, MI, 49503, United States; Spectrum Health Medical Group, Division of Surgical Oncology, 145 Michigan Street NE, Suite 5500, Grand Rapids, MI, 49503, United States.
Am J Surg. 2021 Mar;221(3):525-528. doi: 10.1016/j.amjsurg.2020.12.018. Epub 2020 Dec 9.
The utility of pre-operative MRI in patients with newly diagnosed invasive breast cancer remains a topic of debate. Those who advocate for pre-treatment imaging contend that MRI may detect additional disease not otherwise appreciated on conventional imaging and may provide more accurate staging information to guide treatment. Additionally, it has been proposed that MRI can be utilized to assess extent of residual disease in patients undergoing neoadjuvant chemotherapy. Conversely, those in opposition maintain that routine pre-operative MRI subjects patients to unnecessary ipsilateral mastectomies and prophylactic contralateral mastectomies with no difference in oncologic outcome. When stratified based on tumor biology and patient characteristics, the data suggests that pre-treatment MRI may be advantageous in certain subsets when compared to the general cohort of breast cancer patients. This review recapitulates the current literature on the impact of breast MRI on the surgical management and outcomes of newly diagnosed breast cancer.
术前 MRI 在新诊断浸润性乳腺癌患者中的应用仍然存在争议。支持术前影像学检查的人认为，MRI 可能会检测到常规影像学检查无法发现的其他疾病，并可能提供更准确的分期信息来指导治疗。此外，有人提出 MRI 可用于评估接受新辅助化疗的患者残留疾病的范围。相反，反对者认为，常规术前 MRI 会使患者接受不必要的同侧乳房切除术和预防性对侧乳房切除术，而在肿瘤学结果方面没有差异。根据肿瘤生物学和患者特征进行分层后，数据表明，与乳腺癌患者的一般队列相比，术前 MRI 在某些亚组中可能具有优势。本综述总结了目前关于 MRI 对新诊断乳腺癌的手术管理和结果影响的文献。
