Browsing by Author "Houssami, Nehmat"

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    Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis (MIPA)
    (SPRINGER, 2022-01-01) Sardanelli, Francesco; Trimboli, Rubina M.; Houssami, Nehmat; Gilbert, Fiona J.; Helbich, Thomas H.; Alvarez Benito, Marina; Balleyguier, Corinne; Bazzocchi, Massimo; Bult, Peter; Calabrese, Massimo; Camps Herrero, Julia; Cartia, Francesco; Cassano, Enrico; Clauser, Paola; Cozzi, Andrea; de Andrade, Danubia A.; de Lima Docema, Marcos F.; Depretto, Catherine; Dominelli, Valeria; Forrai, Gabor; Girometti, Rossano; Harms, Steven E.; Hilborne, Sarah; Ienzi, Raffaele; Lobbes I, Marc B.; Losio, Claudio; Mann, Ritse M.; Montemezzi, Stefania; Obdeijn, Inge-Marie; Ozcan, Umit A.; Pediconi, Federica; Pinker, Katja; Preibsch, Heike; Raya Povedano, Jose L.; Sacchetto, Daniela; Scaperrotta, Gianfranco P.; Schiaffino, Simone; Schlooz, Margrethe; Szabo, Botond K.; Taylor, Donna B.; Ulus, Ozden S.; Van Goethem, Mireille; Veltman, Jeroen; Weigel, Stefanie; Wenkel, Evelyn; Zuiani, Chiara; Di Leo, Giovanni
    Objectives Preoperative breast magnetic resonance imaging (MRI) can inform surgical planning but might cause overtreatment by increasing the mastectomy rate. The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue. Methods This observational study enrolled women aged 18-80 years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers. Exclusion criteria included planned neoadjuvant therapy, pregnancy, personal history of any cancer, and distant metastases. Results Of 5896 analyzed patients, 2763 (46.9\%) had conventional imaging only (noMRI group), and 3133 (53.1\%) underwent MRI that was performed for diagnosis, screening, or unknown purposes in 692/3133 women (22.1\%), with preoperative intent in 2441/3133 women (77.9\%, MRI group). Patients in the MRI group were younger, had denser breasts, more cancers >= 20 mm, and a higher rate of invasive lobular histology than patients who underwent conventional imaging alone (p < 0.001 for all comparisons). Mastectomy was planned based on conventional imaging in 22.4\% (MRI group) versus 14.4\% (noMRI group) (p < 0.001). The additional planned mastectomy rate in the MRI group was 11.3\%. The overall performed first- plus second-line mastectomy rate was 36.3\% (MRI group) versus 18.0\% (noMRI group) (p < 0.001). In women receiving conserving surgery, MRI group had a significantly lower reoperation rate (8.5\% versus 11.7\%, p < 0.001). Conclusions Clinicians requested breast MRI for women with a higher a priori probability of receiving mastectomy. MRI was associated with 11.3\% more mastectomies, and with 3.2\% fewer reoperations in the breast conservation subgroup.
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    Solving the preoperative breast MRI conundrum: design and protocol of the MIPA study
    (SPRINGER, 2020-01-01) Sardanelli, Francesco; Trimboli, Rubina M.; Houssami, Nehmat; Gilbert, Fiona J.; Helbich, Thomas H.; Alvarez Benito, Marina; Balleyguier, Corinne; Bazzocchi, Massimo; Bult, Peter; Calabrese, Massimo; Camps Herrero, Julia; Cartia, Francesco; Cassano, Enrico; Clauser, Paola; de Andrade, Danubia A.; de Lima Docema, Marcos F.; Depretto, Catherine; Forrai, Gabor; Girometti, Rossano; Harms, Steven E.; Hilborne, Sarah; Ienzi, Raffaele; Lobbes, Marc B. I.; Losio, Claudio; Mann, Ritse M.; Montemezzi, Stefania; Obdeijn, Inge-Marie; Ozcan, Umit Aksoy; Pediconi, Federica; Preibsch, Heike; Raya-Povedano, Jose L.; Sacchetto, Daniela; Scaperrotta, Gianfranco P.; Schlooz, Margrethe; Szabo, Botond K.; Ulus, Ozden S.; Taylor, Donna B.; Van Goethem, Mireille; Veltman, Jeroen; Weigel, Stefanie; Wenkel, Evelyn; Zuiani, Chiara; Di Leo, Giovanni
    Despite its high diagnostic performance, the use of breast MRI in the preoperative setting is controversial. It has the potential for personalized surgical management in breast cancer patients, but two of three randomized controlled trials did not show results in favor of its introduction for assessing the disease extent before surgery. Meta-analyses showed a higher mastectomy rate in women undergoing preoperative MRI compared to those who do not. Nevertheless, preoperative breast MRI is increasingly used and a survey from the American Society of Breast Surgeons showed that 41\% of respondents ask for it in daily practice. In this context, a large-scale observational multicenter international prospective analysis (MIPA study) was proposed under the guidance of the European Network for the Assessment of Imaging in Medicine (EuroAIM). The aims were (1) to prospectively and systematically collect data on consecutive women with a newly diagnosed breast cancer, not candidates for neoadjuvant therapy, who are offered or not offered breast MRI before surgery according to local practice