Evaluation of Breast Edema Findings at T2-weighted Breast MRI Is                    Useful for Diagnosing Occult Inflammatory Breast Cancer and Can Predict                    Prognosis after Neoadjuvant Chemotherapy

Harada, Taiyo L; Uematsu, Takayoshi; Nakashima, Kazuaki; Kawabata, Takanori; Nishimura, S.; Takahashi, Kaoru; Tadokoro, Yukiko; Hayashi, Takuma; Tsuchiya, Kazuyo; Watanabe, Junichiro; Sugino, Takashi

doi:10.1148/radiol.2021202604

Cited by 39 publications

(23 citation statements)

References 32 publications

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“…Also, our limited sample failed to compare the different prognoses of patients with MRI positivity/pathological malignancy to those with MRI negativity. MRI has been playing an increasingly important role in identifying primary occult lesions and predicting therapeutic effects [29,30]. If an occult focus is found via MRI, it should be excluded from the occult neoplasm in this study.…”

Section: Discussionmentioning

confidence: 99%

Mastectomy and Breast Conserving Therapy Share Comparable Survival and Efficacy on Patients with Occult Breast Cancer: A Retrospective Study in China

Jia

Ren

et al. 2022

Preprint

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Purpose This single-center retrospective study aimed to compare the efficacy of mastectomy and Breast Conserving Therapy (BCT) on overall survival (OS) and disease-free survival (DFS) and examine prognostic factors of Occult Breast Cancer (OBC) in China. Methods We conducted a univariate Kaplan-Meier analysis and a multivariate Cox proportional hazards model on OBC patients in Cancer Hospital, Chinese Academy of Medical Science (CHCAMS), comparing prognostic factors including treatment plans, risk factors, TNM stages, metastasis, and recurrence. Results Seventy patients with OBC undergoing axillary lymph node dissection (ALND) were included with median follow-up of 84.0 months. No statistically significant differences in OS (HR, 1.64; 95% CI, 0.59-4.51; p=0.327) and DFS (HR, 1.83; 95% CI, 0.60-4.89; p=0.200) were observed between mastectomy (n=23) and BCT (n=37). Positive estrogen receptor and progesterone receptor suggested better survival in univariate analysis. Patients with more severe N stage presented inferior survival. The association between radiotherapy and worse survival was probably because patients with higher TNM stages tended to receive radiotherapy. Low Ki-67 level (≤14%) predicted worse outcomes in both univariate and multivariate analyses. Conclusion Mastectomy with ALND presented comparable prognosis outcomes to BCT with ALND for OBC patients.

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Section: Discussionmentioning

confidence: 99%

Mastectomy and Breast Conserving Therapy Share Comparable Survival and Efficacy on Patients with Occult Breast Cancer: A Retrospective Study in China

Jia

Ren

et al. 2022

Preprint

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“…Focal edema, defined as high signal intensity (SI) as that of water on T2WI, were considered present around the tumor mass, or in the prepectoral region, or in the subcutaneous area. In accordance with previous articles about breast edema [ 7 , 8 ], we used the breast edema score (BES) to classify findings of breast edema on T2-weighted images, as follows: BES 1, no edema (Fig. 1 a); BES 2, peritumoral edema (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…Breast focal edema were classified into three different types: peritumoral edema, prepectoral edema, and subcutaneous edema. Furthermore, Uematsu et al firstly used breast edema score (BES) for classification of breast edema findings on T2-weighted MRI scans in 2021 [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

Focal breast edema and breast edema score on T2-weighted images provides valuable biological information for invasive breast cancer

et al. 2023

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Background Various features extracted from breast MRI have the potential to serve as noninvasive biomarkers for the prediction of the biologic behavior of breast cancer. The purpose of this study was to investigate the value of focal breast edema and breast edema score (BES) on T2-weighted images in providing valuable biological information for breast cancer patients’ personalized treatment. Method Two hundred and five lesions in 201 patients with invasive breast cancer confirmed by surgery or biopsy in Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from November 2018 to October 2019 were retrospectively recruited and analyzed in this study. Focal edema and BES were evaluated at fat-suppressed T2 weighted imaging. All the lesions were divided into two groups according to the presence of focal edema. The differences in clinicopathological characteristics between the two groups and between different BES were compared. Results Two hundred and five lesions in 201 patients with invasive breast cancer were retrospectively recruited and analyzed in this study. On the fat-suppressed T2WI, focal edema was detected in 102 of 205 lesions (49.8%). BES was positively correlated with tumor size (p < 0.001), histologic grade (p = 0.006), Ki-67 index (p < 0.001), and N stage (p = 0.007), and was negatively correlated with expression of ER and PR (p < 0.001). Higher BES was more likely to present in patients with non-luminal breast cancer (p < 0.001) and suggested the possibility of a higher N stage. Conclusions Focal edema on T2WI of breast MRI indicates stronger tumor invasiveness, in which non-luminal breast cancer is more inclined to present focal edema. Breast edema score, a novel and practical tool, helps guide the individualized treatment of patients with invasive breast cancer. Graphical Abstract Critical relevance statement Focal edema on T2WI of breast MRI indicates stronger tumor invasiveness. Breast edema score helps guide the individualized treatment of patients with invasive breast cancer.

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“…Magnetic resonance imaging (MRI), an essential tool in breast imaging, is considered to be one of the most sensitive imaging methods for detecting BC and monitoring neoadjuvant chemotherapy ( 9 , 10 ). T2WI can be used to detect bleeding, edema, and cyst in breast lesions ( 11 ). Diffusion-weighted imaging (DWI), a common method to evaluate the micro-architecture of the tumors based on the measurement of the Brownian motion of water molecules, improves the accuracy of breast tumor diagnosis ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Clinical-radiomics nomogram for identifying HER2 status in patients with breast cancer: A multicenter study

Fang

Zhang

et al. 2022

Front. Oncol.

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PurposeTo develop and validate a clinical-radiomics nomogram based on radiomics features and clinical risk factors for identification of human epidermal growth factor receptor 2 (HER2) status in patients with breast cancer (BC).MethodsTwo hundred and thirty-five female patients with BC were enrolled from July 2018 to February 2022 and divided into a training group (from center I, 115 patients), internal validation group (from center I, 49 patients), and external validation group (from centers II and III, 71 patients). The preoperative MRI of all patients was obtained, and radiomics features were extracted by a free open-source software called 3D Slicer. The Least Absolute Shrinkage and Selection Operator regression model was used to identify the most useful features. The radiomics score (Rad-score) was calculated by using the radiomics signature-based formula. A clinical-radiomics nomogram combining clinical factors and Rad-score was developed through multivariate logistic regression analysis. The performance of the nomogram was evaluated using receiver operating characteristic (ROC) curve and decision curve analysis (DCA).ResultsA total of 2,553 radiomics features were extracted, and 21 radiomics features were selected as the most useful radiomics features. Multivariate logistic regression analysis indicated that Rad-score, progesterone receptor (PR), and Ki-67 were independent parameters to distinguish HER2 status. The clinical-radiomics nomogram, which comprised Rad-score, PR, and Ki-67, showed a favorable classification capability, with AUC of 0.87 [95% confidence internal (CI), 0.80 to 0.93] in the training group, 0.81 (95% CI, 0.69 to 0.94) in the internal validation group, and 0.84 (95% CI, 0.75 to 0.93) in the external validation group. DCA illustrated that the nomogram was useful in clinical practice.ConclusionsThe nomogram combined with Rad-score, PR, and Ki-67 can identify the HER2 status of BC.

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Evaluation of Breast Edema Findings at T2-weighted Breast MRI Is Useful for Diagnosing Occult Inflammatory Breast Cancer and Can Predict Prognosis after Neoadjuvant Chemotherapy

Cited by 39 publications

References 32 publications

Mastectomy and Breast Conserving Therapy Share Comparable Survival and Efficacy on Patients with Occult Breast Cancer: A Retrospective Study in China

Mastectomy and Breast Conserving Therapy Share Comparable Survival and Efficacy on Patients with Occult Breast Cancer: A Retrospective Study in China

Focal breast edema and breast edema score on T2-weighted images provides valuable biological information for invasive breast cancer

Clinical-radiomics nomogram for identifying HER2 status in patients with breast cancer: A multicenter study

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