Comparison of Breast MRI Versus Contrast Enhanced Mammography Prior to Surgery in Breast Cancer Patients: a Randomized Controlled Trial
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Breast Cancer
- Sponsor
- University of Arizona
- Locations
- 1
- Primary Endpoint
- Global Costs
- Status
- Withdrawn
- Last Updated
- 2 years ago
Overview
Brief Summary
In current clinical practice, women with biopsy proven breast cancer can be sent for breast magnetic resonance imaging (MRI) or contrast enhanced mammography (CEM) prior to surgery in order to delineate the extent of a known cancer and / or assess for the presence of occult secondary cancers. This study seeks to compare the global costs (based on actual reimbursement rates) of CEM/breast MRI, downstream imaging testing, and diagnostic procedures in women randomized to breast MRI versus CEM. Secondary goals are to compare patient preferences for CEM vs MRI and clinically relevant outcomes (e.g. conversion from lumpectormy to mastecomy).
Detailed Description
This is a pilot randomized controlled trial comparing the global costs of two standard of care imaging techniques in patients with a new breast cancer diagnosis and planned breast conservation surgery. Patients enrolled in this study will be randomized to either CEM or breast MRI. The purpose of this study is to compare the global costs (based on actual reimbursement rates) of initial imaging modality (CEM or breast MRI), downstream imaging related to breast cancer evaluation, and diagnostic breast procedures in women randomized to breast MRI versus CEM. Secondary endpoints include assessment of patient's reported satisfaction with the initial imaging technique received (CEM versus MRI), quantifying differences in health-related quality of life (as assessed by the patient reported Euro quality of life 5D questionnaire), rate of conversion from planned lumpectomy to mastectomy, and rate of re-operation for positive margins.
Investigators
Michael Morris
Clinical Assistant Professor, Radiology
University of Arizona
Eligibility Criteria
Inclusion Criteria
- •Women aged 18 years or older with newly diagnosed breast cancer and planned breast conservation surgery
- •Clinically indicated referral for breast MRI or contrast mammogram prior to surgery
- •Provision of informed consent
Exclusion Criteria
- •Planned neoadjuvant chemotherapy
- •Patients that are medically unstable
- •Pregnancy
- •Patients with known contraindication to contrast mammography, including:
- •Glomerular filtration rate \<30
- •Known adverse reaction to iodinated contrast material
- •Patients with known contraindication to Breast MRI including:
- •Glomerular filtration rate \<30
- •Known adverse reaction to gadolinium contrast material
- •Non-MRI conditional device or catheter
Outcomes
Primary Outcomes
Global Costs
Time Frame: Through Study Completion (2 years)
The Primary outcome is to compare the global costs (based on actual reimbursement rates) of initial imaging modality (CEM or breast MRI), downstream imaging related to breast cancer evaluation, and diagnostic breast procedures in women randomized to breast MRI versus CEM.
Secondary Outcomes
- Rate of Conversion(Through Study Completion (2 years))
- Rate of Re-Operation(Through Study Completion (2 years))
- Patient Satisfaction using modified Likert scale(Through Study Completion (2 years))
- Health-Related Quality of Life(Through Study Completion (2 years))