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Open Access Study protocol

Breast MRI in nonpalpable breast lesions: a randomized trial with diagnostic and therapeutic outcome – MONET – study

Nicky HGM Peters1*, Inne HM Borel Rinkes2, Willem PTM Mali1, Maurice AAJ van den Bosch1, Remmert K Storm3, Peter W Plaisier4, Erwin de Boer5, Adriaan J van Overbeeke6 and Petra HM Peeters7

Author Affiliations

1 Department of Radiology, University Medical Center Utrecht, Heidelberglaan 100, E01.132 3584 CX Utrecht, The Netherlands

2 Department of Surgical Oncology, University Medical Center Utrecht, Heidelberglaan 100, G04.228 3584 CX Utrecht, The Netherlands

3 Department of Radiology, Albert Schweitzer Ziekenhuis, van der Steenhovenplein 1 3300 AK Dordrecht, The Netherlands

4 Department of Surgery, Albert Schweitzer Ziekenhuis, van der Steenhovenplein 1 3300 AK Dordrecht, The Netherlands

5 Department of Radiology, Meander Medisch Centrum, lokatie Lichtenberg, Utrechtseweg 1603813 ES Amersfoort, The Netherlands

6 Department of Surgery, Meander Medisch Centrum, lokatie Lichtenberg, Utrechtseweg 1603813 ES Amersfoort, The Netherlands

7 Clinical epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan 100, STR 6.131 3584 CX Utrecht, The Netherlands

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Trials 2007, 8:40  doi:10.1186/1745-6215-8-40

Published: 28 November 2007

Abstract

Background

In recent years there has been an increasing interest in MRI as a non-invasive diagnostic modality for the work-up of suspicious breast lesions. The additional value of Breast MRI lies mainly in its capacity to detect multicentric and multifocal disease, to detect invasive components in ductal carcinoma in situ lesions and to depict the tumor in a 3-dimensional image. Breast MRI therefore has the potential to improve the diagnosis and provide better preoperative staging and possibly surgical care in patients with breast cancer. The aim of our study is to assess whether performing contrast enhanced Breast MRI can reduce the number of surgical procedures due to better preoperative staging and whether a subgroup of women with suspicious nonpalpable breast lesions can be identified in which the combination of mammography, ultrasound and state-of-the-art contrast-enhanced Breast MRI can provide a definite diagnosis.

Methods/Design

The MONET – study (MR mammography Of Nonpalpable BrEast Tumors) is a randomized controlled trial with diagnostic and therapeutic endpoints. We aim to include 500 patients with nonpalpable suspicious breast lesions who are referred for biopsy. With this number of patients, the expected 12% reduction in surgical procedures due to more accurate preoperative staging with Breast MRI can be detected with a high power (90%). The secondary outcome is the positive and negative predictive value of contrast enhanced Breast MRI. If the predictive values are deemed sufficiently close to those for large core biopsy then the latter, invasive, procedure could possibly be avoided in some women. The rationale, study design and the baseline characteristics of the first 100 included patients are described.

Trial registration

Study protocol number NCT00302120