Rethinking Preoperative MRI in Early Breast Cancer: Who Truly Benefits?

Objective: In light of existing evidence on the use of preoperative magnetic resonance imaging (MRI) in breast cancer (BC) patients undergoing upfront surgery, this study evaluated whether adding MRI to conventional imaging improved the definition of disease extent, subsequent surgical management, and survival outcomes. Materials and Methods: This retrospective study reviewed patients with stage I-II BC who underwent upfront surgery between January 2014 and September 2025. Patients were divided into an MRI cohort and a non-MRI cohort, and clinicopathologic characteristics, the diagnostic performance of ultrasound and MRI in detecting additional malignant foci, the type of surgery, and recurrence during follow-up were compared. Results: = 0.39). Conclusion: Preoperative MRI occasionally changed surgical plans but offered no diagnostic advantage over standard imaging, supporting its selective rather than routine use in upfront BC surgery.