Breast Cancer
Conditions
Brief summary
To see if performing breast MRI before a lumpectomy will help the surgeon successfully remove the entire cancer with normal tissue margins in a single operation thereby reducing the need for additional surgical procedures. The study will also measure how well MRI can find unsuspected cancers in the same breast as the known cancer; how well MRI will find unsuspected cancers in the opposite breast; how often MRI will generate false positive MRI findings; whether routinely incorporating breast MRI delays care or adds unnecessary cost; and, whether breast MRI is able to reduce the frequency of cancer recurrence in the treated breast or elsewhere in the body.
Interventions
PROCEDUREBreast MRI
Sponsors
Stanford University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
DIAGNOSTIC
Masking
NONE
Eligibility
Sex/Gender
FEMALE
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* DCIS less than 5 cm. T1/T2 invasive breast cancer. Patient is a suitable candidate for breast conservation and wishes this as the primary clinical approach * No breast MRI within the past year. Prior core biopsy, but no prior excision allowed. Patient has completed conventional imaging workup with mammography ultrasound as indicated and there is no clinical indication for breast MRI. * Women with age \>= 18. No ethnic restrictions. * No life expectancy restrictions. * Performance status not a factor. * No requirements for organ or marrow function. * Ability to understand and the willingness to sign a written informed consent document.
Exclusion criteria
* Patient is unable to complete a breast MRI due to such factors as hardware and claustrophobia. * No limitations as to other investigational agents. Patients who have received neoadjuvant chemotherapy will not be included in the study due to the limitations of MRI interpretation after neoadjuvant chemotherapy and because this represents a distinct scenario for interpretation of breast MRI in comparison with untreated patients. * There are no comorbidities that would preclude entry into the study unless the patient is unable to lay still for breast MRI scanning. * There are fewer reactions to MRI contrast media, but if there is such a history, the patient will be excluded from consideration. * There are no
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To determine whether pre-lumpectomy breast MRI reduces the frequency of repeat lumpectomy in women with DCIS < 5 cm or T1 or T2 invasive breast cancer | — |
Secondary
| Measure | Time frame |
|---|---|
| To determine how often MRI will miss occult DCIS or invasive cancer subsequently detected on surgical pathology | — |
| To determine how often MRI will detect occult multifocal or multicentric disease | — |
| To determine the frequency with which breast MRI changes the surgical plan | — |
| To measure whether MRI reduces the frequency of repeat lumpectomy to a greater extent in women with mammographically dense vs fatty breasts | — |
| To measure whether preoperative MRI is associated with enhanced postoperative cosmesis | — |
| To determine the frequency of false positive MRI findings requiring biopsy | — |
| To measure the degree and extent to which preoperative MRI lengthens the time required to deliver care | — |
| To measure whether preoperative MRI increases the rate of patient directed (unnecessary) mastectomy | — |
| To measure whether MRI decreases the risk of ipsilateral breast tumor recurrence | — |
| To measure disease-free survival without/with preoperative breast MRI | — |
| To measure overall survival without/with preoperative MRI | — |
| To measure whether preoperative MRI alters cost of care | — |
Outcome results
None listed