Breast MRI could determine need for radiation therapy
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| Image courtesy of Siemens Medical Solutions |
In a retrospective study of 167 patients who underwent radiation therapy for invasive breast cancer after surgical staging, researchers at the Seattle Cancer Care Alliance and University of Washington (UW) Medical Center found that the tumors' physiological information shown on MRI scans correlated with surgically based findings of cancer having spread to lymph nodes.
The investigators said this suggests that breast MRI could help determine if patients scheduled to undergo surgery will later need radiation therapy and how much.
The findings are significant because the standard of care for patients with breast cancer has evolved during the past five years, according to lead author Christopher Loiselle, MD, a resident at the department of radiation oncology at UW Medical Center. In the past, decisions regarding radiation therapy were made after surgery and before chemotherapy, he said.
"When you give chemotherapy first, and then perform the surgery to remove the cancer and sample the lymph nodes, you reduce your ability to know whether there was cancer in the axillary lymph nodes before the patient was treated with chemotherapy," Loiselle said. "This raises the question: is there another way to stage those lymph nodes? Our study showed that tumor characteristics as seen on an MRI scan may be the answer."
The benefit is that some patients can be spared radiation therapy, especially those with smaller tumors and tumors that have not spread to the lymph nodes, he said.
Prospective studies will need to be done to confirm the value of MRI scans in staging tumors for radiation therapy, he noted.