71 Utility of Performing Staging MRI in Breast Cancer Patients Over the Age of 75

Publication
Article
Miami Breast Cancer Conference® Abstracts Supplement41st Annual Miami Breast Cancer Conference® - Abstracts
Volume 38
Issue 4
Pages: 68-69

Utility of Performing Staging MRI in Breast Cancer Patients Over the Age of 75

Utility of Performing Staging MRI in Breast Cancer Patients Over the Age of 75

Background

The purpose of this study is to determine the utility of staging MRI in patients over age 75 with breast cancer. The National Comprehensive Cancer Center guidelines state that MRI may be used for staging MRI, but there is currently no high-level data stating that treatment decision-making based on MRI improves recurrence or overall survival. In the era of de-escalation of treatment, we chose to evaluate if there is a benefit of breast MRI in patients over age 75. We hypothesize that an MRI will change the management of patients over age 75 and therefore provide utility in this population. The secondary aim is to identify factors that might be incorporated into patient-specific decision-making to prevent overtreatment of patients and overuse of resources.

Methods

This is a retrospective review of data from the electronic medical records from 2017 to 2023. Eligible patients include those 75 or older with complete medical records who were diagnosed with breast cancer. Of the eligible patients who received an MRI, we reviewed how many additional biopsies were performed and the percentage of those biopsies that revealed additional malignancies or led to a change in the patient’s overall treatment. Also evaluated were breast density, clinical stage, tumor grade, and tumor receptors.

Results

A total of 316 patients were diagnosed with breast cancer within the study period, and of those patients, 131 (41.4%) received a staging breast MRI. Metastatic disease, claustrophobia, kidney disease, and patient refusal were among the reasons that patients did not receive a staging MRI. Thirty-six (35.2%) patients underwent additional biopsies due to MRI findings and 2 patients opted for mastectomy. Twenty-nine (80.5%) patients were found to have additional malignancies, 2 patients had atypical ductal hyperplasia, and 1 patient had atypical hyperplasia. The patients with additional malignancies were most commonly clinical stage I (65.4%), grade II (69%), hormone receptor positive, and HER2 negative (95.8%) with type B breast density (48%), although these factors were not found to be statistically significant (Table).

Conclusions

Currently we utilize MRI selectively at the discretion of the individual practitioner. In this review, 30 (29.4%) patients over the age of 75 who received MRI had additional cancers that altered their treatment plan. Although this is a limited retrospective study, it does suggest that patients within this population will likely benefit from a staging MRI. This study suggests that age, breast density, hormonal status, and tumor grade may not be appropriate criteria to limit the use of stage MRI in this population. Additional studies are needed to confirm the utility of MRI in this population.

Articles in this issue

44 Variant of Uncertain Significance (VUS) Genetic Testing Results and Mastectomy Choice in Lumpectomy-Eligible Patients
44 Variant of Uncertain Significance (VUS) Genetic Testing Results and Mastectomy Choice in Lumpectomy-Eligible Patients
45 Application of the 7-Gene Biosignature in Palpable Versus Nonpalpable Ductal Carcinoma In Situ in a Black Patient Population: Does Palpability Suggest a More Aggressive Genomic Risk?
45 Application of the 7-Gene Biosignature in Palpable Versus Nonpalpable Ductal Carcinoma In Situ in a Black Patient Population: Does Palpability Suggest a More Aggressive Genomic Risk?
46 Comparative Analysis of Breast Conserving Therapy vs Mastectomy in Multifocal and Multicentric Breast Cancer: A Review of the Literature
46 Comparative Analysis of Breast Conserving Therapy vs Mastectomy in Multifocal and Multicentric Breast Cancer: A Review of the Literature
47 Can We Identify Factors That Predict DCIS Upgrade to Invasive Cancer at Mastectomy?
47 Can We Identify Factors That Predict DCIS Upgrade to Invasive Cancer at Mastectomy?
48 The Era ‘or Error’ of Second Localization Procedures
48 The Era ‘or Error’ of Second Localization Procedures
49 The Influence of Race on Complications in Breast Conservation Surgery: A Single Institution Study
49 The Influence of Race on Complications in Breast Conservation Surgery: A Single Institution Study
51 Ductal Carcinoma In Situ With Microinvasion on Biopsy—What Are the Predictors of Upstaging?
51 Ductal Carcinoma In Situ With Microinvasion on Biopsy—What Are the Predictors of Upstaging?
52 UK Experience of Non-Radioisotope, Non-Magnetic Guided Breast Wide Local Excision and Sentinel Node Biopsy
52 UK Experience of Non-Radioisotope, Non-Magnetic Guided Breast Wide Local Excision and Sentinel Node Biopsy
53 The Utility of Sentinel Lymph Node Biopsy in High-Grade Ductal Carcinoma In Situ
53 The Utility of Sentinel Lymph Node Biopsy in High-Grade Ductal Carcinoma In Situ
54 The Evaluation of Expression Levels of CXCR4, CXCL12, and LASP1 Genes in Peripheral Blood Samples of Breast Cancer Patients
54 The Evaluation of Expression Levels of CXCR4, CXCL12, and LASP1 Genes in Peripheral Blood Samples of Breast Cancer Patients
55 Language as a Barrier to Deep Inspiration Breath Hold (DIBH) Radiation Therapy for Left  Breast Cancer
55 Language as a Barrier to Deep Inspiration Breath Hold (DIBH) Radiation Therapy for Left Breast Cancer
56 Predictive Factors Correlating With Pathologic Complete Response Rates in Racially Diverse, Minority Populations Receiving Neoadjuvant Therapy for HR+/HER2– Breast Cancer
56 Predictive Factors Correlating With Pathologic Complete Response Rates in Racially Diverse, Minority Populations Receiving Neoadjuvant Therapy for HR+/HER2– Breast Cancer
57 Addressing Barriers to Identifying Patients With HER2-Low Metastatic Breast Cancer in a Large Community Oncology Practice
57 Addressing Barriers to Identifying Patients With HER2-Low Metastatic Breast Cancer in a Large Community Oncology Practice
58 Prospective Longitudinal Assessment of Financial Toxicity Among Breast Cancer Patients
58 Prospective Longitudinal Assessment of Financial Toxicity Among Breast Cancer Patients
59 Acceptability of Microbiome Sampling-Based Surgical Oncology Research in Minority Breast Cancer Patients
59 Acceptability of Microbiome Sampling-Based Surgical Oncology Research in Minority Breast Cancer Patients
Related Videos
Pegulicianine-guided breast cancer surgery may allow practices to de-escalate subsequent radiotherapy, says Barbara Smith, MD, PhD.
Barbara Smith, MD, PhD, spoke about the potential use of pegulicianine-guided breast cancer surgery based on reports from the phase 3 INSITE trial.
Carey Anders, MD, an expert on breast cancer
Carey Anders, MD, an expert on breast cancer
Carey Anders, MD, an expert on breast cancer
Carey K. Anders, MD, an expert on breast cancer
A panel of 4 experts on breast cancer seated at a long table
A panel of 4 experts on breast cancer seated at a long table
Related Content