Dynamic contrast-enhanced breast magnetic resonance imaging for the prediction of early and late recurrences in breast cancer

Abstract

The aim of the study was to evaluate dynamic contrast-enhanced breast magnetic resonance imaging (DCE-MRI) features for the prediction of early and late recurrences in patients with breast cancer.Of 1030 breast cancer patients who underwent surgery at our hospital from January 2007 to July 2011, 83 recurrent breast cancer patients were enrolled in this study. We compared MRI features (background parenchymal enhancement [BPE], internal enhancement, adjacent vessel sign, whole-breast vascularity, initial enhancement pattern, kinetic curve types, and quantitative kinetic parameters) and clinico-pathologic variables (age, stage, histologic grade, nuclear grade, existence of lymphovascular invasion and extensive intraductal carcinoma component, and immunohistochemical profiles) between patients with early (≤2.5 years after surgery) and late recurrence (>2.5 years after surgery). Cox proportional hazard regression analysis was performed to evaluate independent risk factors for early and late recurrence.On breast MRI, prominent ipsilateral whole-breast vascularity was independently associated with early recurrence (hazard ratio [HR], 2.86; 95% confidence intervals [CI], 1.39–5.88) and moderate or marked BPE (HR, 2.08; 95% CI, 1.04–4.18) and rim enhancement (HR, 2.14; 95% CI, 1.00–4.59) were independently associated with late recurrence. Clinico-pathologic variables independently associated with early recurrence included negative estrogen receptor (HR, 0.53; 95% CI, 0.29–0.96), whereas T2 stage (HR, 2.08; 95% CI, 1.04–4.16) and nuclear grade III (HR, 2.54; 95% CI, 1.29–4.98) were associated with late recurrence.In DCE-MRI, prominent ipsilateral whole-breast vascularity, moderate or marked BPE, and rim enhancement could be useful for predicting recurrence timing in patients with breast cancer.

Prognostic Factors of Disease Recurrence in Breast Cancer Using Quantitative and Qualitative Magnetic Resonance Imaging (MRI) Parameters

“…Also, increased vascularity always showed significant association with disease recurrence in every multivariable model. Increased vascularity due to the tumor can affect other MRI parameters related to tumor vascularity, including perfusion or texture parameters 13,19 . However, texture and perfusion parameters were associated with disease recurrence independent of increased ipsilateral vascularity in present study.…”

“…Breast MRI is performed in most patients with newly diagnosed breast cancer and can both diagnose breast cancer accurately and predict cancer prognosis using variable imaging features. Previous studies identified that several imaging features including rim enhancement pattern of tumor 13,14 , presence of peritumoral edema on T2-weighted image 15,16 , higher degree of background parenchymal enhancement (BPE), and increased vascularity around the tumor, indicate poor prognosis in breast cancer [13][14][15][16][17] . In addition to morphologic features of tumor, quantitative MRI parameters derived from advanced MR techniques have been recently developed for prediction of breast cancer prognosis.…”

Neoadjuvant Chemotherapy and Surgery for Breast Cancer: Preoperative MRI Features Associated with Local Recurrence

“…Nonmass enhancement was defined as the enhancement of an area that was not a mass, whose internal enhancement characteristics were discrete from the normal surrounding breast parenchyma. In addition, the presence of peritumoral edema and the pattern of tumor shrinkage (concentric or nonconcentric) were also evaluated because these findings have been reported to show an association with LRR (17,(22)(23)(24) or distant metastasis (25). The presence of peritumoral edema was defined when high signal intensity around the tumor or posterior to the tumor mass in the prepectoral area was observed on T2-weighted images (26).…”

Efficacy of Magnetic Resonance Imaging in BIRADS 3, 4 and 5 Patients Detected on Full Filed Digital Mammography: Our Experience

“…Contrast-enhanced breast magnetic resonance imaging (MRI) is an ideal imaging modality that helps in representing tumour angiogenesis. In MRI, the contrast enhanced pattern of the tumour correlates to the micro-vessels density which is a characteristic of tumour angiogenesis [8]. The features of dynamic contrast-enhanced MRI (DCE-MRI) such as washout curve type, peripheral rim enhancement, and faster enhancement are correlated with overall survival and recurrence of breast cancer patients [8].…”