Mastectomies on the Increase

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The new research involved more than 5,000 patients with early-stage breast cancer who underwent surgery between 1997 and 2006. Information on whether an MRI was performed before surgery became available in Mayo Clinic records, starting in 2003.

In 1997, the mastectomy rate was 44 percent. That number declined to 30 percent in 2003, then rose again from 2004 to 2006, to 43 percent.

"That's similar to the rate seen in the late 1990s," Goetz said.

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In 2003, 11 percent of women underwent MRI before their surgery; by 2006, that number had risen to 23 percent.

Fifty-two percent of all patients receiving MRI had a mastectomy, versus 38 percent of women who did not have an MRI.

Mastectomy rates in women who did not have an MRI also increased, from 28 percent in 2003 to 41 percent in 2006.

Nevertheless, Goetz said, "patients who had preoperative MRI were significantly more likely to undergo mastectomy."

But the greater sensitivity of MRI may, in fact, be a double-edged sword.

"Although there has been a lot of excitement about the sensitivity of MRI, there is a significant downside. We don't have evidence that MRI improves our outcome. What we do know is that it finds a lot of things that we don't know the significance of, and many aren't significant," Bleicher.

He added, "I would say this data is phenomenally important, because we're starting to take a step back about the excitement of MRI and look at it through more realistic non-rose-colored glasses."

"Future studies are needed to determine those factors most likely to influence changes in surgical management and whether the changes influence breast cancer outcomes or quality of life," Goetz said.

More information

The National Cancer Institute has more on surgery options for breast cancer patients.

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