MRI Positioning Could Potentially Effect Breast Cancer Surgery

A recent study revealed that patient position for pre-operative breast imaging MRIs may produce deformity of the breast and tumor position, since the operation is performed in a different position.

Typically, patients who undergo a lumpectomy for breast cancer have a preoperative MRI for more extensive information about the tumor. During the MRIs, patients are lying prone (face down) but the surgery is performed with the patient lying supine (face up), according to the study published by Radiology.

"Accounting for change in size and shape caused by displacement and deformation of the tumor between standard imaging in the prone position and operative supine position, our analysis highlights that supine MRI before surgery may provide surgeons with more detailed and accurate information and could lead to effective tumor removal," said lead study author Eva C. Gombos, MD.

Researchers included 12 women who underwent a pre-operative MRI either positioned prone or supine. In the study, half of patients had supine imaging. They measured differences in size, position, and shape of tumor between patients who had a prone MRI and a supine MRI.

"Supine MRI, when performed in addition to standard prone breast MRI, may help detect a remnant tumor and ensure clear margins to prevent re-operation. Among women undergoing breast conserving surgery, 15-40 percent need to have a second operation to remove remnant tumor," said senior author Mehra Golshan, MD.

Researchers discovered that the size and location of the tumor were significantly different depending on the position of the MRI, according to the study.

"If validated in future large studies, intra-operative, and, more importantly, pre-operative supine MRI could be expected to help the surgeon in accurately planning removal of the tumor and reducing the need for re-operation which negatively impacts the patient emotionally, delays post-operative therapy and increases infection rates and cost," Dr Gombos concluded.