Xie Li-Li, Xu Zhi-Hong, Wei Deng-Hui, Xu Chun-Sen
Fujian Medical University Union Hospital, Fuzhou, Fujian Province, China.
Arch Med Sci. 2021 Apr 10;20(5):1597-1603. doi: 10.5114/aoms/120995. eCollection 2024.
The use of preoperative magnetic resonance imaging (MRI) in newly diagnosed breast cancer has been increasing. However, the value of MRI applied to women with newly diagnosed breast cancer remains controversial. Therefore, this study focused on the association between preoperative MRI and surgical outcomes, which include mastectomy rate, breast conservation rate, and re-excision rate.
A systematic literature search was performed by the Wanfang, VIP (Chinese biomedical databases), PubMed, Cochrane Library, and Embase, databases. The keywords were "breast cancer", "magnetic resonance imaging", "mastectomy rate", "re-excision rate", and "breast conservation rate". A random-effects model was used to estimate the proportion of women with various outcomes in the MRI group versus the non-MRI group. The odds ratio (OR) for each surgical outcome was calculated.
4 RCTs (randomized controlled trials) met the eligibility criteria that included a total of 2312 patients with breast cancer. The analysis results of the MRI group versus the non-MRI group were as follows: mastectomy rate of 15% versus 10%, OR = 2.01, 95% CI: 0.79-5.11, = 0.14; breast conservation rate 84% versus 89%, OR = 0.58, 95% CI: 0.29-1.17, = 0.13; re-excision rate 17% versus 19%, OR = 0.76, 95% CI: 0.37-1.54, = 0.45.
There was no significant association between preoperative MRI and surgical outcomes. This study suggested that the use of preoperative MRI should be selective. The results showed that the application of preoperative MRI did not improve the prognosis of breast cancer patients. More randomized trials are needed for further study due to limited randomized trials.
新诊断乳腺癌患者术前磁共振成像（MRI）的应用日益增多。然而，MRI应用于新诊断乳腺癌女性的价值仍存在争议。因此，本研究聚焦于术前MRI与手术结局之间的关联，手术结局包括乳房切除术率、保乳率和再次切除率。
通过万方、维普（中国生物医学数据库）、PubMed、Cochrane图书馆和Embase数据库进行系统的文献检索。关键词为“乳腺癌”“磁共振成像”“乳房切除术率”“再次切除率”和“保乳率”。采用随机效应模型估计MRI组与非MRI组中出现各种结局的女性比例。计算每种手术结局的比值比（OR）。
4项随机对照试验（RCT）符合纳入标准，共纳入2312例乳腺癌患者。MRI组与非MRI组的分析结果如下：乳房切除术率分别为15%和10%，OR = 2.01，95%CI：0.79 - 5.11，P = 0.14；保乳率分别为84%和89%，OR = 0.58，95%CI：0.29 - 1.17，P = 0.13；再次切除率分别为17%和19%，OR = 0.76，95%CI：0.37 - 1.54，P = 0.45。
术前MRI与手术结局之间无显著关联。本研究提示术前MRI的使用应具有选择性。结果表明术前MRI的应用并未改善乳腺癌患者的预后。由于随机试验有限，需要更多的随机试验进行进一步研究。
