Do you recommend breast MRI for patients with invasive lobular breast cancer considering breast conservation therapy?

I agree with @Dr. First Last. I used to get MRIs in women with lobular cancers routinely, but as data have shown no outcome benefit to pre-op MRI and a higher mastectomy rate associated with the use of MRI, I now only get MRIs in patients in whom the surgeon feels that the other imaging is too equivocal to plan for BCT versus mastectomy, or in some women to help with staging before neoadjuvant chemotherapy. This usually means woman with dense breast tissue. I typically don't offer patients with ...

No. Despite the tendency for multifocaility in lobular carcinoma, there is no evidence that MRI improves the outcome when such pts are treated with BCT ( lumpectomy + RT). Older series indicate equivalent outcomes for lobular ca compared with other histologies. The possible explanations for this are twofold - either additional foci of disease are controlled with whole breast RT or they are not biologically significant or a combination of the two. Nonetheless there is an increasing tendency in ma...