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The benefit of breast magnetic resonance imaging (MRI) in breast-conserving surgery (BCS) is unclear. Our study compared breast cancer patients with and without preoperative breast MRI and their long-term oncologic outcomes are reported. A total of 1378 BCS cases with early breast cancer between 1996 and 2017 were reviewed. Patients with carcinoma in situ or neoadjuvant treatment or having breast MRI after tumor excision were excluded. Of 1378 patients, 270 (19.5%) had preoperative MRI. There were no significant differences regarding T and N stage and molecular subtypes between the groups. Surgical margins were significantly wider in the breast MRI group. Five-year overall survival (OS) was 96.9% in the MRI group and 94.3% in the control group, and this difference was not significant (p=0.11). Five-year local-regional recurrence-free survival (LRFS) was not significantly different either (98.8% and 96.5%, respectively, p=0.41). When analyses were repeated only for patients with hormone receptor-negative or triple-negative breast cancer, there was still no significant difference in OS, LRFS, or disease-free survival. In conclusion, MRI does not seem necessary in all patients undergoing BCS. New prospective randomized controlled trials are needed to determine appropriate use of preoperative MRI and its effects on oncologic outcomes in early breast cancer patients., Koristi od magnetske rezonancije (MR) kod operativnog zahvata kojim dojka ostaje očuvana u većoj ili manjoj mjeri (breast-conserving surgery, BCS) ostaju nejasne. U ovoj studiji uspoređene su bolesnice s rakom dojke u kojih je napravljena prijeoperacijska MR i one bez MR (kontrolna skupina) te se navode njihovi dugoročni onkološki ishodi. Pregledani su podatci za 1378 žena s ranim rakom dojke podvrgnutih BCS između 1996. i 2017. godine. Bolesnice s karcinomom in situ ili neoadjuvantnim liječenjem ili pak one kod kojih je učinjena MR nakon ekscizije tumora nisu uključene u istraživanje. Od 1378 bolesnica prijeoperacijska MR učinjena je u njih 270 (19,5%). Nije bilo značajnih razlika između dviju skupina s obzirom na T i N stadij te molekularne podtipove karcinoma. Kirurške granice bile su značajno šire u skupini s MR. Petogodišnje ukupno preživljenje bilo je 96,9% u skupini s MR i 94,3% u kontrolnoj skupini; ova razlika nije bila značajna (p=0,11). Petogodišnje preživljenje bez lokalnog-regionalnog recidiva (local-regional recurrence-free survival, LRFS) također se nije značajno razlikovalo između dviju skupina (98,8% odnosno 96,5%, p=0,41). Kad su analize ponovljene samo za bolesnice s rakom dojke negativnim na receptore ili trostruko negativnim rakom dojke nisu utvrđene nikakve značajne razlike u ukupnom preživljenju, LRFS ili preživljenju bez bolesti. Zaključno, izgleda da MR nije potrebno raditi u svih bolesnica u kojih se planira BCS. Nova prospektivna randomizirana kontrolirana istraživanja su potrebna kako bi se utvrdila odgovarajuća primjena prijeoperacijske MR te njezini učinci na onkološke ishode u bolesnica s ranim rakom dojke.