Impact of breast MRI on the surgical management of young women with breast cancer.

[OBJECTIVE] This study evaluates the impact of preoperative breast MRI on surgical management in young women diagnosed with breast cancer.

[METHODS] A retrospective chart review identified 125 women aged 40 years or younger diagnosed with breast cancer at a university academic practice between January 2015 and December 2020. Twenty-three patients were excluded due to loss of follow-up, resulting in a final sample of 102 patients. Patients were included regardless of surgical plan. Variables analyzed included demographic data, breast cancer risk factors, imaging findings, and subsequent surgical outcomes. Chi-square and Fisher's exact test were used for bivariate analyses. Univariate and multivariate logistic regression were used to assess the association between MRI findings and surgical management.

[RESULTS] Preoperative MRI detected additional findings or lesions warranting biopsy in 53.9 % of cases, with 45.5 % of these lesions confirmed as malignant. Of the confirmed malignancies, 24 were ipsilateral and 1 was contralateral. The detection of additional carcinoma was associated with a 6.34-fold increased likelihood of undergoing mastectomy (aOR: 6.34, 95 % CI: 1.85-29.82). MRI was particularly effective in detecting additional ipsilateral disease, supporting its role in preoperative planning.

[CONCLUSION] Preoperative MRI in women aged 40 years and younger increases the detection of additional malignancies, influencing surgical decisions and supporting its integration into routine preoperative evaluation for improved patient outcomes.