Pat Whitworth MD/

Pre-op Breast MRI: New study shows benefit at the same time ASBrS issues new policy

Alan Hollingsworth's blog:

Excerpt from: https://alanhollingsworth.wordpress.com/2017/05/06/say-it-aint-so-joe/

The American Society of Breast Surgeons announced a new policy statement at its annual meeting in April 2017, regarding the use of breast MRI pre-operatively for women newly diagnosed with breast cancer. Unlike most guidelines that describe what physicians ought to do, this one is quite the opposite – what NOT to do. That is, don’t routinely perform breast MRI pre-operatively to map tumor extent.

The operative word here is “routinely,” with the implication being that surgeons are free to order MRI in selected cases, thus avoiding the more oppressive guideline that has been suggested by some – don’t use MRI at all. This new policy statement sounds perfectly reasonable at first glance. But at second glance, we’re facing an unusual problem – no one has clearly demonstrated specific subsets of patients where MRI yields are higher, that is, more easily justified. We all believe we know where MRI is most likely to help, but so far, attempts to demonstrate these subsets – based on patient age, histology, breast density, etc. – have not shown sharp distinctions in MRI yields or outcomes. It is very difficult to predict in advance when MRI is going to be of benefit...

more: https://alanhollingsworth.wordpress.com/2017/05/06/say-it-aint-so-joe/

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