Meta-Analysis Of The Application Of MRI In Breast Conserving Surgery:A Meta-Analysis

Object This meta-analysis examined the impact of MRI on breast conserving surgery.Methods A systematic review(MEDLINE,the Cochrane Central Register of Controlled Trials,PubMed,EMBASE,Chinese Biomedical Database,China National Knowledge Infrastructure Database and VIP database)was performed to identify studies that used a controlled design and reported MRI and breast conserving surgical outcomes of any type of breast cancer.Random-effects logistic regression was used to calculate the pooled odds ratio(OR)for outcomes,and adjusted ORs which stratified by study-level median age.Subgroup analysis for invasive lobular cancer(ILC)was also performed.Results There were 17 eligible studies(3 RCTs;14 comparative studies)including newly diagnosed breast cancer of any type except for three cohorts restricted to ILC.Evidence showed that pre-operative MRI was not associated with re-excision surgery ? mastectomy or positive margins;MRI significantly decreased re-excision rate(OR = 0.45,95% CI:0.21~0.96,P=0.04)of the breast cancer patients who were younger thanthe study-level median age in analyses stratified by study-level median age.Subgroup analysis for ILC found MRI was associated with decreased odds of receiving mastectomy converted from breast conserving surgery as treatment in breast cancer patients(OR = 0.52,95% CI:0.35~0.77,P =0.001).Conclusion The evidence suggests an unfavorable harm-benefit ratio for routine use of preoperative MRI in breast cancer.And patients younger than the study-level median age and patients with ILC benefit from MRI in this study.