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Publications

Journal Article Ppublish

PubMed: 42317020 DOI: 10.4274/ejbh.galenos.2026.2026-2-10

Survey of the Senologic International Society (SIS) on the Use of Preoperative Breast MRI in Early-Stage Breast Cancer: A Global Perspective on Current Practice.

Eur J Breast Health 22(3):328-339

Authors: Alexander Mundinger, Carolin Mundinger, Darius Dian, Thorsten Heilmann, Shigeru Imoto, Atilla Soran, Wendie A Berg, Tolga Ozmen, Mitsuhiro Tozaki, Katja Siegmann-Luz, Ayfer Kamali Polat, Salete de Jesus Fonseca Rêgo, Pieter De Visschere, Sylvia H Heywang-Köbrunner, Dionysios Koufoudakis, Bolivar Arboleda-Osorio, Maurício Magalhães Costa, Tadeusz Pieńkowski, Paula Podolski, Vahit Ozmen, Schlomo Schneebaum, Constanze Elfgen, Lydia Ioannidou-Mouzaka, Marianna Telesca, Manisha Bahl, Makus Müller-Schimpfle, Vaidotas Cesna, Siarhei Kharuzhyk, Carole Mathelin

Affiliations

  • Breast Center Osnabrück; Niels-Stensen-Kliniken, Franziskus-Hospital Harderberg, Georgsmarienhütte, Germany.
  • Department of Behavioural Biology, University of Muenster, Muenster, Germany.
  • Gyn-Munich and AWOgyn, Munich, Germany.
  • Kyorin University Hospital, Tokyo, Japan.
  • Magee-Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
  • Department of Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.
  • Division of Gastrointestinal and Oncologic Surgery, Section of Breast Surgery, Department of Surgery, Massachusetts General Hospital, Massachusetts, USA.
  • Department of Radiology, Sagara Hospital Affiliated Breast Center, Kagoshima, Japan.
  • Reference Center Mammography, Berlin, Germany.
  • Department of Surgery, Ondokuz Mayıs University, Samsun, Türkiye.
  • Department of Radiology, Antonio Pedro University, Fluminense/UFF, Rio de Janeiro, Brazil.
  • Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium.
  • Reference Center, Munich, Germany.
  • Breast Center Nicosia General Hospital, Nicosia, Cyprus.
  • Universidad Central del Caribe School of Medicine, Puerto Rico, USA.
  • National Academy of Medicine, Rio de Janeiro, Brazil.
  • Department of Oncology and Breast Disease, Postgraduate Medical Education Center, Warsaw, Poland.
  • Croatian Senologic Society, University Hospital Centre Zagreb, Zagreb, Croatia.
  • İstanbul Florence Nightingale Hospital, İstanbul, Türkiye.
  • Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
  • Breast Center Zurich, Switzerland, University of Witten/Herdecke, Department for Human Medicine, Germany.
  • Hellenic Senologic Society, Athens, Greece.
  • Worcestershire Acute Hospitals NHS Trust, United Kingdom.
  • Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
  • Department of Radiology, Neuroradiology and Nuclear Medicine, Frankfurt Höchst Clinics GmbH, Frankfurt, Germany.
  • Department of Breast Surgery, Lithuanian University of Health Sciences Kauno Klinikos, Kaunas, Lithuania.
  • Department of Radiology, N.N. Alexandrov National Cancer Centre, Department of Radiodiagnostics, Institute of Posgraduate Education, Belarusian State Medical University, Minsk, Belarus.
  • Institut de Cancérologie Strasbourg, Europe (ICANS), Strasbourg, France.

Abstract

OBJECTIVE

To map global practice patterns and disparities in the use of preoperative breast magnetic resonance imaging (MRI) for early breast cancer (EBC) among members of the Senologic International Society (SIS) and SIS Working Group.

MATERIALS AND METHODS

A cross-sectional, web-based survey was distributed to SIS members worldwide. The questionnaire captured respondent demographics, center characteristics, local/national breast MRI use, guideline perceptions and personal practice, specific indications for MRI, and decision-making influences.

RESULTS

We analyzed 114 responses from 17 countries. Significant variations were observed. While 36/46 (78.3%) of Japanese respondents perceived national guidelines as recommending preoperative MRI, only 18/60 (30%) of Europeans did. Overall, 96/114 (84.2%) of all respondents believed preoperative MRI provided a patient benefit, with none believing it caused harm. The most frequent indications in the total cohort were invasive lobular carcinoma (106/114, 93.0%), mammographic/sonographic suspicion of multifocality/multicentricity (96/114, 84.2%) and planned neoadjuvant therapy (89/114, 78.1%), while in Japan ductal carcinoma in situ (DCIS) or accompanying DCIS component was the most frequent indication (45/46, 97.8%). Half of respondents stated that national guidelines recommend preoperative breast MRI for EBC (57/114, 50%). Furthermore, 30/57 (52.6%) of these "guideline-positive" respondents reported performing more MRIs than advised while most guidelines recommending only selected preoperative indications such as invasive lobular histopathology, dense breasts, suspicion of multifocality/multicentricity or imaging inconsistencies. Key influencing factors included specialty, reimbursement, and time to access preoperative MRI.

CONCLUSION

This SIS-based international survey revealed heterogeneous global adoption of preoperative breast MRI for EBC, highlighting a significant gap between evidence-based guidelines and real-world practice. Clinical decisions are heavily influenced by geography, culture and resources, and belief in patient benefit. These findings highlight the need to tailor guidelines to local contexts, and strengthen awareness and dissemination efforts, together with further research to clarify the role of MRI in the modern multidisciplinary management of EBC.

MeSH

Genes, Sis, Breast Neoplasms, Neoplasms, Magnetic Resonance Imaging, Carcinoma, Intraductal, Noninfiltrating, Breast