Classification System for Identifying Women at Risk for Altered Partial Breast Irradiation Recommendations After Breast Magnetic Resonance Imaging

MR Imaging for Selection of Patients for Partial Breast Irradiation: A Systematic Review and Meta-Analysis

“…In fact, both patient characteristics are associated with a higher probability of multifocal or multicentric cancers (8,18,19). Six studies (9,11,(20)(21)(22)(23) were finally included, the sample size ranged from 260 to 715 patients (total, 3136 patients), and 1435 patients (46%) were eligible to undergo PBI at standard assessment. Detailed characteristics of the analyzed studies are presented in Table 1.…”

“…Detailed characteristics of the analyzed studies are presented in Table 1. Four studies had a retrospective design (9,11,20,23), one had a prospective design (22), and one reported on both a retrospective and a prospective series of patients (21). In all studies, (12).…”

“…For data pooling, Cochrane Q and I 2 statistics were first calculated to assess heterogeneity of the included studies (Fig 4). Subgroup analysis that compared invasive cancers and ductal carcinoma in situ was performed in four studies (11,(21)(22)(23) and showed a high statistical homogeneity (I 2 , 0%; P = .528), with a pooled OR (fixed-effect model) of 1.6 (95% CI: 1.0, 2.4; P = .031) for a higher probability of ineligibility to undergo PBI in patients with invasive cancers than those with ductal carcinoma in situ (Fig 5).…”

“…Subgroup analysis that compared premenopausal women with postmenopausal women was performed in four studies (11,(21)(22)(23). Analysis showed a high statistical homogeneity (I 2 , 0%; P = .536), which resulted in a pooled OR (fixed-effect model) of 1.9 (95% CI: 1.3, 2.6; P , .001) for a higher probability of ineligibility to undergo PBI for only patients eligible to undergo PBI on the basis of a standard assessment underwent MR imaging.…”

“…Eligibility criteria for PBI on the basis of a standard assessment were substantially homogeneous across studies; four studies (9,11,21,23) applied criteria from the National Surgical Adjuvant Breast and Bowel Project (known as the NSABP) B-39 criteria (24) and two studies (21,22) applied a slight modification of NSABP B-39 criteria. Criteria that altered eligibility for PBI after MR imaging were also substantially homogeneous, mainly determined by the detection of multicentric or synchronous contralateral disease.…”