Preoperative breast cancer staging with multi-modality imaging and surgical outcomes

Abstract Purpose To compare the rates of mastectomy and re-operation after breast-conserving surgery(BCS) among patients who had different pre-operative multi-modality imaging, hence identifying significant predictors of mastectomy and re-operations within each group. Method Retrospective study of consecutive patients with primary breast cancer treated January2010–December2016, divided in 3 groups, undergoing pre-operative local staging respectively with conventional imaging modalities only (2D mammography, ultrasound (US)), conventional imaging and tomosynthesis (DBT) and/or MRI. The primary outcome was identification of significant predictors of surgical outcomes, within each group. Study variables examined in univariate analysis were age, lesion dimension, breast density, multifocality, tumor size, histology, and if associated with outcomes they were included in binary logistic regression analysis. Results Amongst 1547 patients, patient and tumor characteristics differed across the three groups, as did mastectomy rates which were 18% (102/562) for 2D + US, 36% (154/428) for 2D + DBT + US, 45% (250/557) for 2D+/-DBT + US + MRI(p  Conclusions Patients who had larger tumors and multifocal disease were more frequently staged by adding DBT and/or MRI to conventional imaging (mammography and US) which was associated with more extensive surgical treatment but lower reoperation rates.