{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T03:28:37Z","timestamp":1782185317570,"version":"3.54.5"},"reference-count":58,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T00:00:00Z","timestamp":1700784000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100004326","name":"Bayer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004326","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012352","name":"Universit\u00e0 degli Studi di Milano","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100012352","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Objectives<\/jats:title>\n                <jats:p>To investigate the influence of preoperative breast MRI on mastectomy and reoperation rates in patients with pure ductal carcinoma in situ (DCIS).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The MIPA observational study database (7245 patients) was searched for patients aged 18\u201380\u00a0years with pure unilateral DCIS diagnosed at core needle or vacuum-assisted biopsy (CNB\/VAB) and planned for primary surgery. Patients who underwent preoperative MRI (MRI group) were matched (1:1) to those who did not receive MRI (noMRI group) according to 8 confounding covariates that drive referral to MRI (age; hormonal status; familial risk; posterior-to-nipple diameter; BI-RADS category; lesion diameter; lesion presentation; surgical planning at conventional imaging). Surgical outcomes were compared between the matched groups with nonparametric statistics after calculating odds ratios (ORs).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Of 1005 women with pure unilateral DCIS at CNB\/VAB (507 MRI group, 498 noMRI group), 309 remained in each group after matching. First-line mastectomy rate in the MRI group was 20.1% (62\/309 patients, OR 2.03) compared to 11.0% in the noMRI group (34\/309 patients, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). The reoperation rate was 10.0% in the MRI group (31\/309, OR for reoperation 0.40) and 22.0% in the noMRI group (68\/309, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), with a 2.53 OR of avoiding reoperation in the MRI group. The overall mastectomy rate was 23.3% in the MRI group (72\/309, OR 1.40) and 17.8% in the noMRI group (55\/309, <jats:italic>p<\/jats:italic>\u2009=\u20090.111).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Compared to those going directly to surgery, patients with pure DCIS at CNB\/VAB who underwent preoperative MRI had a higher OR for first-line mastectomy but a substantially lower OR for reoperation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Clinical relevance statement<\/jats:title>\n                <jats:p>When confounding factors behind MRI referral are accounted for in the comparison of patients with CNB\/VAB-diagnosed pure unilateral DCIS, preoperative MRI yields a reduction of reoperations that is more than twice as high as the increase in overall mastectomies.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p>\u2022 <jats:italic>Confounding factors cause imbalance when investigating the influence of preoperative MRI on surgical outcomes of pure DCIS.<\/jats:italic><\/jats:p>\n                <jats:p>\u2022 <jats:italic>When patient matching is applied to women with pure unilateral DCIS, reoperation rates are significantly reduced in women who underwent preoperative MRI.<\/jats:italic><\/jats:p>\n                <jats:p>\u2022 <jats:italic>The reduction of reoperations brought about by preoperative MRI is more than double the increase in overall mastectomies.<\/jats:italic><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-023-10409-5","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T05:02:05Z","timestamp":1700802125000},"page":"3970-3980","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Preoperative breast MRI positively impacts surgical outcomes of needle biopsy\u2013diagnosed pure DCIS: a patient-matched analysis from the MIPA study"],"prefix":"10.1007","volume":"34","author":[{"given":"Andrea","family":"Cozzi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Di Leo","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 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Gilbert received research grants from General Electric Healthcare, GSK, and Hologic, and had research collaborations with Volpara and Bayer AG. She is an NIHR senior investigator and receives funding from the Cambridge BRC.Marc B. I. Lobbes received research grants from and is a member of the speakers\u2019 bureau of General Electric Healthcare.Katja Pinker declares being part of speakers bureaus for the European Society of Breast Imaging (active), Bayer AG (ended), Siemens Healthineers (ended), DKD 2019 (ended), and Olea Medical (ended); consulting for Genentech, Merantix Healthcare, AURA Health Technologies, and Guerbet.Paola Clauser and Katja Pinker are part of the Scientific Editorial Board of <i>European Radiology<\/i>, and Rossano Girometti is Deputy Editor of <i>European Radiology<\/i>. As such, none of them had any role in handling this manuscript and none of them took part in the decision processes.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 first three authors (A.C., G.D.L, N.H.) 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 center on January 29, 2013 (Comitato Etico Ospedale San Raffaele, Milano, Italy; protocol number 2784), and thereafter by local Ethics Committees of participating centers.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This paper is a targeted subanalysis of 1005 patients that were previously included in the main paper of the MIPA study (Sardanelli et al, European Radiology 2022; ) and in the paper comparing patients with different MRI referrals (Cozzi et al, European Radiology 2023; ).","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"value":"\u2022 prospective\u2022 observational\u2022 multicenter study","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}