A major new study has found that preoperative breast magnetic resonance imaging (MRI) does not improve local regional control in women with early-stage triple-negative or HER2-positive breast cancer. The findings were presented at the San Antonio Breast Cancer Symposium, held from December 9 to 12.

The research, led by Dr. Isabelle Bedrosian of The University of Texas MD Anderson Cancer Center, evaluated whether MRI contributed to better treatment outcomes among women newly diagnosed with stage I and II breast cancer who were candidates for breast-conserving surgery (BCS). The study enrolled 319 participants, randomly assigning them either to receive a breast MRI as part of local staging or to proceed without additional imaging.

No Difference in Recurrence or Survival

Most patients—about 85%—received systemic chemotherapy, with 17.6% undergoing treatment before surgery. Nearly all women (93.4%) underwent surgery, and the rate of breast-conserving surgery was nearly identical in both groups: 92.7% in the no-MRI group versus 91.9% in the MRI group.

After a median follow-up period of 61 months, researchers found no significant difference in local regional recurrence (LRR) rates. Five-year local regional control stood at 95.7% for the no-MRI group and 93.2% for those who underwent MRI. Distant recurrence-free survival and overall survival were also comparable across the two groups, with rates of 94.3% and 92.2%, respectively.

Routine Preoperative MRI Not Necessary, Researchers Say 

Dr. Bedrosian emphasized that the findings challenge the perceived value of MRI in surgical planning for these aggressive breast cancer subtypes.

“Our results further imply that there is no clinical utility to using preoperative MRI for the diagnostic workup of breast cancer patients to guide surgical treatment,” she said. “We conclude that the routine use of MRI in this context is not warranted.”

A Step Toward More Targeted Use of Imaging

The study adds to growing evidence suggesting that while MRI is a powerful diagnostic tool, it may not offer additional benefits in all patient groups. For early-stage triple-negative and HER2-positive breast cancer—diseases already treated aggressively—standard imaging and current surgical approaches appear sufficient for local regional control