MRI for breast cancer assessed

News release from NETSCC, HTA

12 January 2010

The addition of magnetic resonance imaging (MRI) to the initial, pre-operative assessment of women with small breast cancers does not reduce the re-operation rate for incompletely excised tumour, suggests research published by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme.

The number of women having a repeat operation or mastectomy, following initial lumpectomy, for incompletely excised breast cancer rose from 14 per cent to 17 per cent in 2006/7. This is a considerable additional burden to both the patient and the NHS. To help reduce this rate the NHS is considering whether to recommend the addition of MRI to mammography for the assessment of breast cancer. However, there is limited evidence about its effectiveness.

Professor Lindsay Turnbull of the University of Hull and her team have completed the largest clinical trial of its kind into this aspect of MRI. They assessed whether the addition of MRI to the current method of patient evaluation by triple assessment (clinical examination, imaging (mammography and ultrasound) and biopsy) would aid breast tumour localisation and reduce the re-operation rate in women with primary tumours. They also evaluated the cost to the NHS of adding MRI to the assessment process.

Of 1623 women recruited to take part in the trial, 816 were randomised to receive MRI and 807 to receive no MRI. The results showed no differences in the re-operation rate between these two groups. The re-operation rate was 18.75 per cent for the MRI patients and 19.33 per cent for the 'no’ MRI patient group. The economic analysis indicated that the addition of MR imaging to the triple assessment would cost more but offered few or no benefits in terms of clinical outcome or quality of life.

“These results are important from both from the patient’s perspective and a health economic aspect,” says Professor Lindsay Turnbull. “The findings of this trial demonstrate that although MRI provided the best assessment of the extent and location of tumour present in the breast, this information could not be utilised by surgeons using currently accepted techniques to reduce the re-operation rate, and therefore did not benefit patients. Knowing this will allow time and resources to be more effectively used elsewhere. This is important for both the NHS and for women with breast cancer.”

This study has published in Health Technol Assess 2010, Vol 14:01. To view the full results visit www.hta.ac.uk/1216

Notes for editors

 1. The National Institute for Health Research Health Technology Assessment (NIHR HTA) programme commissions research about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS. It is the largest NIHR programme and publishes the results of its research in the Health Technology Assessment journal, with over 530 issues published to date. The journal’s 2009 Impact Factor (4.197) ranked it in the top 10% of medical and health-related journals. All issues are available for download free of charge from the website, www.hta.ac.uk

2. The National Institute for Health Research provides the framework through which the research staff and research infrastructure of the NHS in England is positioned, maintained and managed as a national research facility. The NIHR provides the NHS with the support and infrastructure it needs to conduct first-class research funded by the Government and its partners alongside high-quality patient care, education and training. Its aim is to support outstanding individuals (both leaders and collaborators), working in world class facilities (both NHS and university), conducting leading edge research focused on the needs of patients. www.nihr.ac.uk

Contact details

Naomi Williams, Programme Manager (Communications)
Telephone: 02380 595 646, Email: N.E.Williams@southampton.ac.uk

Emma Sunderland, Assistant Programme Manager (Communications)
Telephone: 02380 599 094, Email: E.Sunderland@southampton.ac.uk

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