Open AccessFactors Associated with Preoperative Magnetic Resonance Imaging Use among Medicare Beneficiaries with Nonmetastatic Breast Cancer
Author(s) -
Henderson Louise M.,
Weiss Julie,
Hubbard Rebecca A.,
O'Donoghue Cristina,
DeMartini Wendy B.,
Buist Diana S. M.,
Kerlikowske Karla,
Goodrich Martha,
Virnig Beth,
Tosteson An. A.,
Lehman Constance D.,
Onega Tracy
Publication year - 2015
Publication title -
the breast journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.533
H-Index - 72
eISSN - 1524-4741
pISSN - 1075-122X
DOI - 10.1111/tbj.12522
Subject(s) - medicine , breast mri , breast cancer , magnetic resonance imaging , mastectomy , ductal carcinoma , radiology , stage (stratigraphy) , mammography , lobular carcinoma , logistic regression , epidemiology , breast conserving surgery , cancer , oncology , paleontology , biology
Preoperative breast magnetic resonance imaging ( MRI ) use among Medicare beneficiaries with breast cancer has substantially increased from 2005 to 2009. We sought to identify factors associated with preoperative breast MRI use among women diagnosed with ductal carcinoma in situ ( DCIS ) or stage I–III invasive breast cancer ( IBC ). Using Surveillance, Epidemiology, and End Results and Medicare data from 2005 to 2009 we identified women ages 66 and older with DCIS or stage I–III IBC who underwent breast‐conserving surgery or mastectomy. We compared preoperative breast MRI use by patient, tumor and hospital characteristics stratified by DCIS and IBC using multivariable logistic regression. From 2005 to 2009, preoperative breast MRI use increased from 5.9% to 22.4% of women diagnosed with DCIS and 7.0% to 24.3% of women diagnosed with IBC . Preoperative breast MRI use was more common among women who were younger, married, lived in higher median income zip codes and had no comorbidities. Among women with IBC , those with lobular disease, smaller tumors (<1 cm) and those with estrogen receptor negative tumors were more likely to receive preoperative breast MRI . Women with DCIS were more likely to receive preoperative MRI if tumors were larger (>2 cm). The likelihood of receiving preoperative breast MRI is similar for women diagnosed with DCIS and IBC . Use of MRI is more common in women with IBC for tumors that are lobular and smaller while for DCIS MRI is used for evaluation of larger lesions.