Correlation between High Resolution Dynamic MR Features and Prognostic Factors in Breast Cancer

Abstract

ObjectiveTo correlate high resolution dynamic MR features with prognostic factors in breast cancer.Materials and MethodsOne hundred and ninety-four women with invasive ductal carcinomas underwent dynamic MR imaging using T1-weighted three-dimensional fast low-angle shot (3D-FLASH) sequence within two weeks prior to surgery. Morphological and kinetic MR features were determined based on the breast imaging and reporting data system (BI-RADS) MR imaging lexicon. Histological specimens were analyzed for tumor size, axillary lymph node status, histological grade, expression of estrogen receptor (ER), expression of progesterone receptor (PR), and expression of p53, c-erbB-2, and Ki-67. Correlations between the MR features and prognostic factors were determined using the Pearson χ2 test, linear-by-linear association, and logistic regression analysis.ResultsBy multivariate analysis, a spiculated margin was a significant, independent predictor of a lower histological grade (p < 0.001), and lower expression of Ki-67 (p = 0.007). Rim enhancement was significant, independent predictor of a higher histological grade (p < 0.001), negative expression of ER (p = 0.001), negative expression of PR (p < 0.001) and a larger tumor size (p = 0.006). A washout curve may predict a higher level of Ki-67 (p = 0.05). Most of the parameters of the initial enhancement phase cannot predict the status of the prognostic factors. Only the enhancement ratio may predict a larger tumor size (p = 0.05).ConclusionOf the BI-RADS-MR features, a spiculated margin may predict favorable prognosis, whereas rim enhancement or washout may predict unfavorable prognosis of breast cancer.

Detection and classification of contrast‐enhancing masses by a fully automatic computer‐assisted diagnosis system for breast MRI

“…This finding was not confirmed by a recently published study (36); however, strongest initial enhancement was significantly associated with negative ER and PR status in this investigation (36). Regarding morphologic criteria, spiculated margin has been shown to be a significant independent predictor of lower histologic tumor grade, rim enhancement a significant independent predictor of higher tumor grade, of negative ER and PR status as well as of larger histologic tumor size (39). In our study, we found no significant differences between the calculations of the MDI and histologic characteristics of the carcinomas, such as histologic subtypes, tumor grade, or receptor status.…”

Imaging Features of HER2 Overexpression in Breast Cancer: A Systematic Review and Meta-analysis

“…Kim and colleagues did not find a relation between HER2 status and initial slope, peak enhancement, time to peak enhancement, or washout ratio (76). Lee and colleagues found no relation between initial slope and HER2 status (79), and Youk and colleagues found no relation between early-phase percentage enhancement and HER2 status (92). Again following Figure 4.…”

“…No DCE-MRI study excluded patients based on receptor expression. Restricting the meta-analysis to three studies with sub-mm in plane resolution and smaller than 2-mm slice thickness (68,69,79) showed that rim enhancement also increased the chance of HER2 overexpression (pOR, 2.92; 95% CI, 1.42-6.02; P < 0.01; 2 studies; Supplementary Figs. S76-S80).…”

Prediction of pathological complete response of breast cancer patients undergoing neoadjuvant chemotherapy: usefulness of breast MRI computer-aided detection

“…2,3 Previous studies have shown that the size of residual tumours and the response of a tumour to neoadjuvant chemotherapy are related to the recurrence-free survival rate. [4][5][6][7][8] It was also exhibited 8,9 that neoadjuvant chemotherapy could lead to a pathological complete response (pCR) in up to 30% of patients with breast cancers, and these patients showed a better survival outcome than patients with residual cancers. This result emphasizes that prediction of chemotherapeutic effects before treatment could be critical for a successful cancer treatment.…”