MRIs May Have Fueled Increase In Mastectomy
Older breast cancer patients had significantly higher odds of undergoing mastectomy if their evaluation included MRI, use of which increased exponentially during the study period, investigators reported.
Breast MRI was associated with an increase of more than 20 percent in the likelihood of mastectomy versus breast-conserving surgery in women 65 and older. An MRI exam also was associated with tripled odds of bilateral cancer diagnosis and bilateral mastectomy, as compared with age-matched breast cancer patients who did not have breast MRI.
The mastectomy findings coincided with an overall increase in use of breast MRI from <1% to more than 25% of all breast cancer patients, Cary P. Gross, MD, of Yale University, and colleagues reported online in Breast Cancer Research and Treatment.
"Recent studies have ... demonstrated the adoption of newer and more expensive breast cancer screening and treatment approaches in the Medicare population, with scant evidence to support them," the authors concluded. "Our study suggests that breast imaging may be considered in a similar category. It is expensive, affects clinical care, yet has little evidence to support its use.
"It is time for policymakers to invest in a comprehensive approach to study breast cancer management among older women with breast cancer."