This weeks Lancet:
An interesting article on the potential utility for MRI in initial work up of breast cancer. While a prior trial in the NEJM (link) demonstrated that one could detect occult cancers in the contralateral breast in 3% of patients (by biopsying 12%), this trial looked at the utility of MRI in surgical planning in the ipsilateral breast. The short of it: no difference in reoperation rates for positive or close margins. MRI seems to becoming more of a standard preoperative test, however the only clinically relevant outcome reported as yet is an increase in the mastectomy rate (link).
Link to the Lancet
[Articles] Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomised controlled trial: "MRI might improve diagnosis of breast cancer, reducing rates of reoperation. We assessed the clinical efficacy of contrast-enhanced MRI in women with primary breast cancer."