Breast Magnetic Resonance Imaging: Are Those Who Need It Getting It?

Abstract

Background Indications for breast magnetic resonance imaging (mri), a very sensitive but less-specific tool for

Utilization of breast MRI and breast MRI-guided biopsy in clinical practice: results of a survey in Québec and France

“…Despite a lack of consensus as noted by several authors [3,4], criteria employed to recommend preoperative breast MRI exams were consistent both within and also between both countries. Unsurprisingly, in both countries, the three most frequently cited variables considered for breast MRI in patients with newly diagnosed breast cancer were pathologic features, age, and breast density [3,5]. Of particular note, the surgeon's opinion was also an important consideration in Québec, much more so than in France.…”

“…Of particular note, the surgeon's opinion was also an important consideration in Québec, much more so than in France. Although this factor has not been extensively evaluated in recent studies [3,5], it emphasizes the role of breast surgeons in the era of multidisciplinary approach, which is in agreement with Evidence-Based Medicine (EBM) guidelines [14]. Indeed, EBM integrates the best external evidence with individual clinical expertise and the patients' choices [14].…”

“…Indications for performing preoperative breast MRI are still debatable with a recent tendency to decrease preoperative staging breast MRI exams, particularly in the absence of high-level evidence from randomized controlled trials demonstrating benefits of breast MRI in terms of survival [3,13]. Despite a lack of consensus as noted by several authors [3,4], criteria employed to recommend preoperative breast MRI exams were consistent both within and also between both countries. Unsurprisingly, in both countries, the three most frequently cited variables considered for breast MRI in patients with newly diagnosed breast cancer were pathologic features, age, and breast density [3,5].…”

“…This subject has historically been a more sensitive issue in Québec and Canada than in France [23,24], likely due to the fact that although waiting times are audited in most institutions in both countries, this is more frequently done in Québec (80% versus 68%). Specifically, waiting times for breast MRI exams have been a particular source of concern [3]. Currently, Quebec governmental guidelines recommend a maximal delay of 90 days after reception of the first request whereas French recommendations based on "Plan Cancer 2014-2019" encourage a maximal average delay of 21 days [3,25].…”

“…Recently, its indications have dramatically increased, including screening, diagnosis, and staging [2]. However, breast MRI indications vary among radiologists and among hospitals, given the general lack of consensus [3], and its use as a preoperative staging tool remains a controversial topic [4].…”