Objectives To assess the impact of preoperative MRI on long-term survival outcomes in women with ductal carcinoma in situ (DCIS). Materials and methods This retrospective study included women diagnosed with DCIS between January 2007 and December 2016. Propensity scores based on 25 demographic and clinicopathologic covariates were used to generate an overlap-weighted cohort, balancing patient groups according to MRI use. Recurrence-free survival (RFS) and overall survival (OS) were compared using Kaplan–Meier estimates with log-rank test and Cox proportional hazards models. Results Among 1003 eligible women (mean age, 48.6 years ± 9.4 [SD]), 624 (62.2%) underwent MRI. During a median follow-up of 9.5 years, 122 (12%) experienced recurrence, including 75 (61%) invasive events. The 15-year recurrence rates did not differ between the MRI and no-MRI groups (27% vs 23%; p = 0.77). Preoperative MRI was not associated with recurrence in the overlap-weighted cohort (hazard ratio (HR), 0.88 [95% CI: 0.60, 1.30]; p = 0.53). The 15-year overall mortality rate was 7% in both groups (p = 0.93), and preoperative MRI was not associated with overall mortality in the overlap-weighted cohort (HR, 1.21 [95% CI: 0.55, 2.66]; p = 0.64). Preoperative MRI was not an independent factor for RFS (HR, 0.99 [95% CI: 0.71, 1.39]; p = 0.95) or OS (HR, 1.11 [95% CI: 0.52, 2.37]; p = 0.78). Conclusion Preoperative breast MRI was not associated with improved RFS or OS among women with DCIS. Key Points <Emphasis Type="BoldItalic">Question</Emphasis> The impact of preoperative MRI on long-term outcomes in women with ductal carcinoma in situ (DCIS) remains uncertain. <Emphasis Type="BoldItalic">Findings</Emphasis> In this retrospective propensity score–weighted analysis, preoperative breast MRI was not associated with improved recurrence-free survival or overall survival in women with DCIS. <Emphasis Type="BoldItalic">Clinical relevance</Emphasis> Routine preoperative MRI may not improve long-term outcomes in DCIS. Prospective multicenter studies are warranted to identify subgroups that may derive meaningful survival benefits. Graphical Abstract

Preoperative breast MRI and long-term survival in ductal carcinoma in situ: a propensity score–weighted analysis

期刊论文
发表日期：

2026年7月6日

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Hee Jeong Kim,
Woo Jung Choi,
Ga Young Yoon,
Hye Joung Eom,
Eun Young Chae,
Hee Jung Shin,
Joo Hee Cha,
Hak Hee Kim

摘要

Objectives

To assess the impact of preoperative MRI on long-term survival outcomes in women with ductal carcinoma in situ (DCIS).

Materials and methods

This retrospective study included women diagnosed with DCIS between January 2007 and December 2016. Propensity scores based on 25 demographic and clinicopathologic covariates were used to generate an overlap-weighted cohort, balancing patient groups according to MRI use. Recurrence-free survival (RFS) and overall survival (OS) were compared using Kaplan–Meier estimates with log-rank test and Cox proportional hazards models.

Results

Among 1003 eligible women (mean age, 48.6 years ± 9.4 [SD]), 624 (62.2%) underwent MRI. During a median follow-up of 9.5 years, 122 (12%) experienced recurrence, including 75 (61%) invasive events. The 15-year recurrence rates did not differ between the MRI and no-MRI groups (27% vs 23%; p = 0.77). Preoperative MRI was not associated with recurrence in the overlap-weighted cohort (hazard ratio (HR), 0.88 [95% CI: 0.60, 1.30]; p = 0.53). The 15-year overall mortality rate was 7% in both groups (p = 0.93), and preoperative MRI was not associated with overall mortality in the overlap-weighted cohort (HR, 1.21 [95% CI: 0.55, 2.66]; p = 0.64). Preoperative MRI was not an independent factor for RFS (HR, 0.99 [95% CI: 0.71, 1.39]; p = 0.95) or OS (HR, 1.11 [95% CI: 0.52, 2.37]; p = 0.78).

Conclusion

Preoperative breast MRI was not associated with improved RFS or OS among women with DCIS.

Key Points

Question The impact of preoperative MRI on long-term outcomes in women with ductal carcinoma in situ (DCIS) remains uncertain.

Findings In this retrospective propensity score–weighted analysis, preoperative breast MRI was not associated with improved recurrence-free survival or overall survival in women with DCIS.

Clinical relevance Routine preoperative MRI may not improve long-term outcomes in DCIS. Prospective multicenter studies are warranted to identify subgroups that may derive meaningful survival benefits.

Graphical Abstract