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The Multicenter International Prospective Analysis (MIPA) study investigated this controversial issue.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This observational study enrolled women aged 18\u201380\u00a0years with biopsy-proven breast cancer, who underwent MRI in addition to conventional imaging (mammography and\/or breast ultrasonography) or conventional imaging alone before surgery as routine practice at 27 centers. Exclusion criteria included planned neoadjuvant therapy, pregnancy, personal history of any cancer, and distant metastases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 5896 analyzed patients, 2763 (46.9%) had conventional imaging only (noMRI group), and 3133 (53.1%) underwent MRI that was performed for diagnosis, screening, or unknown purposes in 692\/3133 women (22.1%), with preoperative intent in 2441\/3133 women (77.9%, MRI group). Patients in the MRI group were younger, had denser breasts, more cancers\u2009\u2265\u200920\u00a0mm, and a higher rate of invasive lobular histology than patients who underwent conventional imaging alone (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for all comparisons). Mastectomy was planned based on conventional imaging in 22.4% (MRI group) versus 14.4% (noMRI group) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The additional planned mastectomy rate in the MRI group was 11.3%. The overall performed first- plus second-line mastectomy rate was 36.3% (MRI group) versus 18.0% (noMRI group) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In women receiving conserving surgery, MRI group had a significantly lower reoperation rate (8.5% versus 11.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinicians requested breast MRI for women with a higher a priori probability of receiving mastectomy. MRI was associated with 11.3% more mastectomies, and with 3.2% fewer reoperations in the breast conservation subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:italic>\u2022 In 19% of patients of the MIPA study, breast MRI was performed for screening or diagnostic purposes.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>\u2022 The current patient selection to preoperative breast MRI implies an 11% increase in mastectomies, counterbalanced by a 3% reduction of the reoperation rate.<\/jats:italic>\n                    <\/jats:p>\n                    <jats:p>\n                      <jats:italic>\u2022 Data from the MIPA study can support discussion in tumor boards when preoperative MRI is under consideration and should be shared with patients to achieve informed decision-making.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-021-08240-x","type":"journal-article","created":{"date-parts":[[2021,10,13]],"date-time":"2021-10-13T09:45:43Z","timestamp":1634118343000},"page":"1611-1623","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":66,"title":["Magnetic resonance imaging before breast cancer surgery: results of an observational multicenter international prospective analysis\u00a0(MIPA)"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6545-9427","authenticated-orcid":false,"given":"Francesco","family":"Sardanelli","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rubina M.","family":"Trimboli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nehmat","family":"Houssami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiona J.","family":"Gilbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas H.","family":"Helbich","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"\u00c1lvarez Benito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corinne","family":"Balleyguier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Bazzocchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Bult","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Calabrese","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Camps Herrero","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cartia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Cassano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Clauser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Cozzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan\u00fabia A.","family":"de Andrade","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcos F.","family":"de Lima Docema","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Depretto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Dominelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00e1bor","family":"Forrai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rossano","family":"Girometti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven E.","family":"Harms","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Hilborne","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Ienzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc B. 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Gilbert received research grants from General Electric Healthcare, GSK and Hologic, and had research collaborations with Volpara and Bayer.Marc B.I. Lobbes received a research grant and is a member of the speakers\u2019 bureau of General Electric Healthcare.Katja Pinker declares funding by the NIH\/NCI Cancer Centre Support Grant P30 CA008748, Digital Hybrid Breast PET\/MRI for Enhanced Diagnosis of Breast Cancer (HYPMED), H2020\u2014Research and Innovation Framework Programme PHC-11-2015 # 667211-2, A Body Scan for Cancer Detection using Quantum Technology (CANCERSCAN), H2020-FETOPEN-2018-2019-2020-01 # 828978, Multiparametric 18F-Fluoroestradiol PET\/MRI coupled with Radiomics Analysis and Machine Learning for Prediction and Assessment of Response to Neoadjuvant Endocrine Therapy in Patients with Hormone Receptor+\/HER2\u2212 Invasive Breast Cancer 02.09.2019\/31.08.2020 # Nr: 18207, Jubil\u00e4umsfonds of the Austrian National Bank.Simone Schiaffino received travel support from Bracco Imaging and is a member of the speakers\u2019 bureau for General Electric Healthcare.All other authors declare that they have no conflict of interest related to the present work and that they have nothing to disclose.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The third author (Nehmat Houssami, The University of Sydney) and the last author (Giovanni Di Leo, IRCCS Policlinico San Donato) have significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was obtained from all patients in this study, unless waived by local Ethics Committees.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"This study was approved by the Ethics Committee of the coordinating centre on January 29, 2013 (protocol number 2784) and thereafter by local Ethics Committees of participating centres.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}