Grupo Oncoclínicas-SP, São Paulo, SP, Brazil.
Hospital da Mulher- SP, São Paulo, SP, Brazil.
Ann Surg Oncol. 2024 Nov;31(12):8021-8029. doi: 10.1245/s10434-024-15833-5. Epub 2024 Jul 27.
The purpose of this study was to review and summarize the association between preoperative magnetic resonance imaging (MRI) and surgical outcomes in women with newly diagnosed invasive breast cancer from published randomized controlled trials (RCT).
Two independent researchers conducted a systematic review through a comprehensive search of electronic databases, including PubMed, Medline, Embase, Ovid, Cochrane Library, and Web of Science. If there was disagreement between the two reviewers, a third reviewer assessed the manuscript to determine whether it should be included for data extraction. The quality of the papers was assessed using the risk of bias tool, and the evidence was analyzed using GRADE. Meta-analyses using a fixed-effects model were used to estimate the pooled risk ratio (RR) and 95% confidence interval (CI).
Initially, 21 studies were identified, 15 of which were observational comparative studies. A total of five RCTs were included, and they suggested that preoperative MRI significantly reduced the rate of immediate breast-conserving surgery and increased the risk for mastectomy.
From the RCT perspective, preoperative MRI for newly diagnosed invasive breast cancer did not improve surgical outcomes and may increase the risk of mastectomy.
本研究旨在通过对已发表的随机对照试验(RCT)进行系统回顾和总结,探讨新诊断为浸润性乳腺癌女性的术前磁共振成像(MRI)与手术结果之间的关系。
两名独立研究人员通过全面检索电子数据库(包括 PubMed、Medline、Embase、Ovid、Cochrane 图书馆和 Web of Science)进行了系统评价。如果两名审稿人存在分歧,将由第三名审稿人评估手稿,以确定是否应纳入数据提取。使用偏倚风险工具评估论文的质量,并使用 GRADE 分析证据。使用固定效应模型进行荟萃分析,以估计合并风险比(RR)和 95%置信区间(CI)。
最初确定了 21 项研究,其中 15 项为观察性对比研究。共纳入 5 项 RCT,结果表明术前 MRI 显著降低了即刻保乳手术率,并增加了乳房切除术的风险。
从 RCT 的角度来看,新诊断为浸润性乳腺癌的患者术前 MRI 并不能改善手术结果,反而可能增加乳房切除术的风险。