European radiology · 2026
Preoperative breast MRI and long-term survival in ductal carcinoma in situ: a propensity score-weighted analysis.
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Kim Hee Jeong, Choi Woo Jung, Yoon Ga Young, Eom Hye Joung, Chae Eun Young, Shin Hee Jung, Cha Joo Hee, Kim Hak Hee
Аннотация
OBJECTIVES: To assess the impact of preoperative MRI on long-term survival outcomes in women with ductal carcinoma in situ (DCIS).
MATERIALS AND METHODS: This retrospective study included women diagnosed with DCIS between January 2007 and December 2016. Propensity scores based on 25 demographic and clinicopathologic covariates were used to generate an overlap-weighted cohort, balancing patient groups according to MRI use. Recurrence-free survival (RFS) and overall survival (OS) were compared using Kaplan-Meier estimates with log-rank test and Cox proportional hazards models.
RESULTS: Among 1003 eligible women (mean age, 48.6 years ± 9.4 [SD]), 624 (62.2%) underwent MRI. During a median follow-up of 9.5 years, 122 (12%) experienced recurrence, including 75 (61%) invasive events. The 15-year recurrence rates did not differ between the MRI and no-MRI groups (27% vs 23%; p = 0.77). Preoperative MRI was not associated with recurrence in the overlap-weighted cohort (hazard ratio (HR), 0.88 [95% CI: 0.60, 1.30]; p = 0.53). The 15-year overall mortality rate was 7% in both groups (p = 0.93), and preoperative MRI was not associated with overall mortality in the overlap-weighted cohort (HR, 1.21 [95% CI: 0.55, 2.66]; p = 0.64). Preoperative MRI was not an independent factor for RFS (HR, 0.99 [95% CI: 0.71, 1.39]; p = 0.95) or OS (HR, 1.11 [95% CI: 0.52, 2.37]; p = 0.78).
CONCLUSION: Preoperative breast MRI was not associated with improved RFS or OS among women with DCIS.
KEY POINTS: Question The impact of preoperative MRI on long-term outcomes in women with ductal carcinoma in situ (DCIS) remains uncertain. Findings In this retrospective propensity score-weighted analysis, preoperative breast MRI was not associated with improved recurrence-free survival or overall survival in women with DCIS. Clinical relevance Routine preoperative MRI may not improve long-term outcomes in DCIS. Prospective multicenter studies are warranted to identify subgroups that may derive meaningful survival benefits.
MATERIALS AND METHODS: This retrospective study included women diagnosed with DCIS between January 2007 and December 2016. Propensity scores based on 25 demographic and clinicopathologic covariates were used to generate an overlap-weighted cohort, balancing patient groups according to MRI use. Recurrence-free survival (RFS) and overall survival (OS) were compared using Kaplan-Meier estimates with log-rank test and Cox proportional hazards models.
RESULTS: Among 1003 eligible women (mean age, 48.6 years ± 9.4 [SD]), 624 (62.2%) underwent MRI. During a median follow-up of 9.5 years, 122 (12%) experienced recurrence, including 75 (61%) invasive events. The 15-year recurrence rates did not differ between the MRI and no-MRI groups (27% vs 23%; p = 0.77). Preoperative MRI was not associated with recurrence in the overlap-weighted cohort (hazard ratio (HR), 0.88 [95% CI: 0.60, 1.30]; p = 0.53). The 15-year overall mortality rate was 7% in both groups (p = 0.93), and preoperative MRI was not associated with overall mortality in the overlap-weighted cohort (HR, 1.21 [95% CI: 0.55, 2.66]; p = 0.64). Preoperative MRI was not an independent factor for RFS (HR, 0.99 [95% CI: 0.71, 1.39]; p = 0.95) or OS (HR, 1.11 [95% CI: 0.52, 2.37]; p = 0.78).
CONCLUSION: Preoperative breast MRI was not associated with improved RFS or OS among women with DCIS.
KEY POINTS: Question The impact of preoperative MRI on long-term outcomes in women with ductal carcinoma in situ (DCIS) remains uncertain. Findings In this retrospective propensity score-weighted analysis, preoperative breast MRI was not associated with improved recurrence-free survival or overall survival in women with DCIS. Clinical relevance Routine preoperative MRI may not improve long-term outcomes in DCIS. Prospective multicenter studies are warranted to identify subgroups that may derive meaningful survival benefits.