Kefah Mokbel, Chair of Breast Cancer Surgery at London Breast Institute and Honorary Professor of Medicine at Cardiff University School of Medicine, shared a post on LinkedIn:
“Preoperative MRI in DCIS: No Survival Benefit at 15 Years
A propensity score-weighted analysis of 1,003 women with DCIS (Kim et al., European Radiology, July 2026) provides the longest follow-up data yet on this question – median 9.5 years, some patients followed to 15 years.
Key findings, using overlap-weighting across 25 clinicopathologic covariates:
- 15-year recurrence: 27% (MRI) vs 23% (no MRI) – no significant difference
- Recurrence HR: 0.88 (95% CI 0.60–1.30), p = 0.53
- 15-year overall mortality: 7% in both groups
- OS HR: 1.21 (95% CI 0.55–2.66), p = 0.64
Preoperative MRI was not an independent predictor of recurrence-free or overall survival in this cohort.
This adds to a consistent signal from the invasive breast cancer literature. Randomized data – not just retrospective cohorts – tell the same story: the BREAST-MRI trial (524 patients, phase III RCT) found no difference in overall survival with preoperative MRI (95.3% vs 96.3%, HR 1.37, p = 0.8). And at SABCS 2025, the Alliance A011104/ACRIN 6694 phase III trial reported no improvement in oncologic outcomes with preoperative MRI staging in stage I–II, HR-negative breast cancer.
Across both DCIS and invasive disease, preoperative MRI continues to add detection and, at times, surgical escalation – without a demonstrated survival dividend. The clinical value of MRI in appropriately selected cases remains real, but routine use as a survival-improving intervention is not supported by the current evidence, randomized or otherwise.
Prospective, multicentre work is still needed to define subgroups – if any – where MRI meaningfully changes long-term outcomes.”
Title: Preoperative breast MRI and long-term survival in ductal carcinoma in situ: a propensity score–weighted analysis
Authors: Hee Jeong Kim, Woo Jung Choi, Ga Young Yoon, Hye Joung Eom, Eun Young Chae, Hee Jung Shin, Joo Hee Cha, Hak Hee Kim
Read the Full Article.
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