Correlation of Whole-Breast Vascularity with Ipsilateral Breast Cancers Using Contrast-Enhanced MDCT

Abstract

ing tumor. However, vascularity can increase not only within a breast cancer lesion but also in the ipsilateral breast as a whole. Recently, some studies have estimated whole-breast vascularity by laser Doppler perfusion imaging [15], PET [16], and MRI [17][18][19] and found an association between breast cancer and an ipsilateral increase of blood flow.Although contrast-enhanced CT of the breast has been used for assessment of axillary lymph node metastasis [20,21], diagnosis of local recurrence after breast-conserving surgery [22], or imaging intraductal extension of breast cancer preoperatively [23], it can also show tumor vascularity. Especially, MDCT can display high-quality angiographic images because of improved temporal and spatial resolution. However, to the best of our knowledge, there has been no study on imaging vascularity of breast cancer using con- AJR 2008; 190:496-504 0361-803X/08/1902-496 © American Roentgen Ray Society A ngiogenesis (also known as neovascularization) is the formation of new capillaries from the existing vascular network [1]. Because vascular blood flow provides nutrients for tumor growth and a mechanism for hematogenous spread of malignant cells [2,3], tumor angiogenesis has been reported to be an independent prognostic indicator in breast cancer [4][5][6][7][8]. Although tumor vasculature has mostly been investigated by immunohistochemical methods using factor VIII staining of endothelial cells to determine microvessel density (MVD) [9,10], this invasive method is difficult to reproduce and standardize [11]. Many imaging angiogenesis methods in vivo have recently been developed, including color Doppler sonography [12] and contrast-enhanced MRI [13,14], and most of them have focused on measurement of angiogenesis in the immediate vicinity of the grow- OBJECTIVE. The purpose of our study was to assess the increase in whole-breast vascularity in patients with unilateral breast cancer and correlate that increase with prognostic factors of breast cancer. Wo m e n's I m ag i ng • O r ig i n a l R e s e a rc h MATERIALS AND METHODS.We performed 16-MDCT on 143 consecutive patients with histologically confirmed breast cancer. One hundred three of these 143 patients were finally enrolled in the study after exclusion of patients with bilateral breast cancer, previous history of neoadjuvant chemotherapy, breast surgery, or lack of surgical confirmation. Breast vascularity was assessed according to the number, length, and conspicuity of vessels on maximum-intensity-projection images. Increase of whole-breast vascularity of the cancer-bearing breast was categorized as not increased, mild, moderate, or prominent compared with the contralateral breast. Breast vascularity was then correlated to prognostic factors including tumor size, lymph node status, cancer stage, nuclear and histologic grade, presence of an extensive intraductal component, presence of hormone receptors, and expression of C-erb-B2.RESULTS. In 77 (74.8%) of 103 patients, breast cancers were found to be associated with i...

Magnetic Resonance Imaging Enhancement Features Before and After Neoadjuvant Chemotherapy in Patients With Breast Cancer

“…We also evaluated the usefulness of IIWBV for an early prediction of the response, because our previous study identified IIWBV as predicting poor prognostic indicators (tumor size, lymph node status, and nuclear and histological grade). 26,38 In this study, however, there was no significant difference (P = 0.068) in the degree of IIWBV on baseline or follow-up MRI between responders and nonresponders. Furthermore, the change in IIWBV after NAC was not correlated with the response (P = 0.081).…”

“…The degree of vascularity differences was classified as ''prominent'' if the number of vessels in the cancer-bearing breast was higher by 3 or more than those in contralateral breast, ''moderate'' if higher by 2, ''mild'' if higher by 1, and ''not increased'' if the number of vessels in ipsilateral breast was same as or lower than that of contralateral breast. 26 …”

Bilateral analysis of the cross-sectional area of the internal mammary arteries and veins in patients with and without breast cancer on breast magnetic resonance imaging

“…Different imaging modalities were used for imaging increased vascularity, for example, laser Doppler perfusion imaging [18], positron emission tomography [19], computed tomography (CT) [20] and MRI [4–6, 8, 10, 21–23]. With respect to MRI, most researchers use one of two methods to assess changes in vascularity in the presence of malignancy.…”

Comparison of Internal Mammary Artery and Lateral Thoracic Artery Width in Patients with Benign and Malignant Breast Tumors

“…Previous studies have been carried out on this subject. Studies comparing whether vascularization in the breast with lesion is increased in comparison with the contralateral breast through subjective methods without measuring vessel diameters are in the majority (10)(11)(12). In a study by Kang et al (11) it has been observed that vascularization has increased globally in the breast with lesion; however, vascular diameter has not been addressed, and only malignant cases were included in the study.…”