Preoperative Breast MRI detects additional cancers

A paper by Bae et al published in Radiology indicates that preoperative MRI in women whose breast cancer was detected by ultrasound found additional cancers.

The study was a retrospective review of 374 women, median age, 48 years, with breast cancer detected at screening ultrasound.

Of 374 women, 21 or 5.6% patients were diagnosed with additional cancer.  In premenopausal women with invasive breast cancer and in those with index invasive lobular histologic type had higher incidence of additional cancer detected at MR imaging.  Premenopausal status also put the women at risk.

The authors concluded that preoperative MRI detected additional sites of cancer in women with breast cancer detected at screening ultrasound.

Ultrasound is ineffective in the healing of bone fractures

A study published in the BMJ suggests that low-intensity pulsed ultrasound, used to speed healing of bone fractures, may be ineffective.

A randomized clinical trial that involved 501 patients who had surgical repair of fractures of the tibia found that patients treated with the low-intensity pulsed ultrasound (LIPUS) healed at the same rate as those given a sham treatment.

Patients self administer daily LIPUS (n=250) or use a sham device (n=251) until their tibial fracture showed radiographic healing or until one year after intramedullary fixation.

Primary registry specified outcome was time to radiographic healing within one year of fixation; secondary outcome was rate of non-union. Additional protocol specified outcomes included short form-36 (SF-36) physical component summary (PCS) scores, return to work, return to household activities, return to ≥80% of function before injury, return to leisure activities, time to full weight bearing, scores on the health utilities index (mark 3), and adverse events related to the device.

Results showed no impact on SF-36 PCS scores between LIPUS and control groups or for the interaction between time and treatment; minimal important difference is 3-5 points or in other functional measures. There was also no difference in time to radiographic healing. There were no differences in safety outcomes between treatment groups. Patient compliance was moderate; 73% of patients administered ≥50% of all recommended treatments.

It was concluded that postoperative use of LIPUS after tibial fracture fixation does not accelerate radiographic healing and fails to improve functional recovery.