Study Finds Pre-Operative MRI May Improve Long-Term Outcomes for Younger Breast Cancer Patients

New research has found that pre-operative MRI scans may lead to better long-term outcomes for women undergoing surgery for breast cancer.

Published in Radiology, the journal of the Radiological Society of North America (RSNA), the study shows that patients who receive MRI scans before surgery experience improved outcomes, particularly women under the age of 50 at diagnosis and treatment.

While pre-operative MRI is a common tool in breast cancer management, it is not yet considered a universal standard. Experts involved in the study suggest that incorporating pre-surgical MRI more broadly could help radiologists better predict the likelihood of cancer recurrence and guide treatment decisions to optimize patient care.

For the analysis, researchers reviewed data from more than 4,400 women aged 50 and younger who were diagnosed with breast cancer and underwent surgery. Not all participants received pre-operative MRI scans. The study compared the outcomes of those who did and did not have the imaging, focusing on cancer recurrence and mortality rates. The patients were followed for a median of nearly eight years.

Among the study participants, 93% had undergone pre-operative MRI prior to surgery. Overall, about 8% of the women experienced cancer recurrence during the follow-up period. The researchers found that rates of ipsilateral in-breast recurrence—meaning cancer returning in the same breast—were roughly half as high in the MRI group compared with those who did not receive MRI (1.6% versus 3.3%). However, overall recurrence rates between the two groups showed no significant differences.

A subanalysis of the data explored how hormone receptor status influenced outcomes. Women with hormone receptor–negative breast cancer appeared to benefit more from pre-operative MRI than those with receptor–positive disease. Recurrence occurred in 8.2% of the receptor–negative group who had MRIs, compared with 20.7% of those without. Despite this difference, overall survival rates were similar between the two groups.

“Undergoing preoperative MRI was associated with reduced risk of ipsilateral in-breast recurrence in patients 50 years or younger with breast cancer, with the greatest benefit observed in those with hormone receptor–negative cancers,” said Heera Yoen, MD, of the Department of Radiology at Seoul National University Hospital, and colleagues.

The findings suggest that pre-operative MRI could play a more significant role in surgical planning and risk assessment, particularly for younger women and those with hormone receptor–negative breast cancer. The study’s abstract is available through Radiology.