Impact of breast MRI on the surgical management of young women with breast cancer.

OBJECTIVE

This study evaluates the impact of preoperative breast MRI on surgical management in young women diagnosed with breast cancer.

METHODS

A retrospective chart review identified 125 women aged 40 years or younger diagnosed with breast cancer at a university academic practice between January 2015 and December 2020. Twenty-three patients were excluded due to loss of follow-up, resulting in a final sample of 102 patients. Patients were included regardless of surgical plan. Variables analyzed included demographic data, breast cancer risk factors, imaging findings, and subsequent surgical outcomes. Chi-square and Fisher's exact test were used for bivariate analyses. Univariate and multivariate logistic regression were used to assess the association between MRI findings and surgical management.

RESULTS

Preoperative MRI detected additional findings or lesions warranting biopsy in 53.9 % of cases, with 45.5 % of these lesions confirmed as malignant. Of the confirmed malignancies, 24 were ipsilateral and 1 was contralateral. The detection of additional carcinoma was associated with a 6.34-fold increased likelihood of undergoing mastectomy (aOR: 6.34, 95 % CI: 1.85-29.82). MRI was particularly effective in detecting additional ipsilateral disease, supporting its role in preoperative planning.

CONCLUSION

Preoperative MRI in women aged 40 years and younger increases the detection of additional malignancies, influencing surgical decisions and supporting its integration into routine preoperative evaluation for improved patient outcomes.