Preoperative MRI Fails to Improve Outcomes in Early HR-Negative Breast Cancer

Five-year randomized data presented at SABCS show outcomes matching standard care without added imaging.

Overview

In the Phase III Alliance A011104/ACRIN 6694 trial, five-year locoregional recurrence was 93.2% with MRI versus 95.7% without MRI (HR 1.14; 95% CI 0.33–3.90; P = .8326).
Distant recurrence-free survival and overall survival were virtually identical between arms, with approximately 94% DRFS and 92% OS at five years.
The multicenter study randomized 319 patients with clinical stage I–II, hormone receptor–negative disease who were eligible for breast-conserving surgery and had no known BRCA1/2 mutations.
Investigators noted that routine preoperative MRI adds testing, can delay surgery, and increases costs, without demonstrating an oncologic advantage in this population.
Small subgroup findings, including in patients receiving neoadjuvant chemotherapy, were inconclusive, and analyses of MRI-detected additional lesions are ongoing.