Preoperative Breast MRI Use Does Not Negatively Impact Women’s Perceptions of Surgical Treatment Decisions

New BCSC Study evaluates self-report of decision quality and regret with breast cancer surgical treatment in women with and without preoperative breast MRI

Posted by Karen Wernli at 8:00 AM on Aug 12, 2022


In a recent article from the BCSC, Dr. Wernli and co-authors including three patient partners (Ms. Jackson-Nefertiti, Ms. Budesky and Ms. Johnson) evaluated women’s perspectives about breast cancer surgery quality and any regret associated with their surgical treatment decisions. Prior studies have suggested that the use of breast MRI might negatively impact longer term women’s perceptions of decision quality and regret with breast cancer treatment. The study investigators compared women’s perspectives in women that did and did not receive breast MRI in either screening or work-up of their breast cancer. To do this study, the researchers conducted a survey with 957 women within 18 months of their breast cancer diagnosis from 7 BCSC registries from across the country. The survey asked women questions about their experience with breast cancer treatment and lingering impacts. Overall, 46% of women reported use of breast MRI prior to breast cancer surgery. They found that women who did have a breast MRI had a small and significant increase in decision quality compared with women who did not receive a breast MRI. Decision quality is a measure of the shared decision-making conversation in treatment decisions. Further, study investigators found that there was no difference in decision regret. They also studied whether these results were different by breast density and found that the results remained similar. The study findings are important because they demonstrate that use of breast MRI prior to breast cancer surgery does not negatively alter women’s perspectives in early survivorship. It is important to note that the study included a population with a high proportion of women who are >60 years, White, college-educated and diagnosed with early-stage breast cancer. Study outcomes might differ in a more diverse population of women. Few studies have published on patient centered outcomes associated with advanced imaging used during the work-up period of breast cancer, and these findings fill a critical gap in understanding the downstream consequences of these choices.

Wernli KJ, Smith RE, Henderson LM, Zhao W, Durham DD, Schifferdecker K, Kaplan C, Buist DSM, Kerlikowske K, Miglioretti DL, Onega T, Alsheik NH, Sprague BL, Jackson-Nefertiti G, Budesky J, Johnson D, Tosteson ANA. Decision quality and regret with treatment decisions in women with breast cancer: Pre-operative breast MRI and breast density. Breast Cancer Res Treat. 2022 Aug;194(3):607-616. doi: 10.1007/s10549-022-06648-7. Epub 2022 Jun 20. PMID: 35723793. [Link]


Posted by: Karen Wernli