Magnetic Resonance in the Detection of Breast Cancers of Different Histological Types

Mayrhofer, Rebecca M.; Ng, Howard P.; Putti, Thomas Choudary; Kuchel, Philip W.

doi:10.4137/mri.s10640

Cited by 9 publications

(12 citation statements)

References 123 publications

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“…[4][5] The response rate after NACHT is an important overall survival indicator in LABC patients; particularly, the complete pathological response (pCR) induction is predictive to a successful long-term survival. [6][7] Several studies validated the role of magnetic resonance imaging (MRI) over other diagnostic exams to assess the response rate after NACHT, [8][9][10] and there is a great interest in evaluating whether tumor radiologic features provided by MRI (like signal intensity, tumor enhancement, and morphology) may serve as indicators of tumor response to NACHT. 11 However, few of them have been carried out to evaluate the tumor regression pattern as a possible early response predictor and, to the best of our knowledge, no study investigated its correlation with the different tumor biological subtypes.…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy

et al. 2017

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The objective of this study is to analyze magnetic resonance imaging shrinkage pattern of tumor regression after neoadjuvant chemotherapy and to evaluate its relationship with biological subtypes and pathological response. We reviewed the magnetic resonance imaging studies of 51 patients with single mass-enhancing lesions (performed at time 0 and at the II and last cycles of neoadjuvant chemotherapy). Tumors were classified as Luminal A, Luminal B, HER2+, and Triple Negative based on biological and immunohistochemical analysis after core needle biopsy. We classified shrinkage pattern, based on tumor regression morphology on magnetic resonance imaging at the II cycle, as concentric, nodular, and mixed. We assigned a numeric score (0: none; 1: low; 2: medium; 3: high) to the enhancement intensity decrease. Pathological response on the surgical specimen was classified as complete (grade 5), partial (grades 4-3), and non-response (grades 1-2) according to Miller and Payne system. Fisher test was used to relate shrinkage pattern with biological subtypes and final pathological response. Seventeen patients achieved complete response, 25 partial response, and 9 non-response. A total of 13 lesions showed nodular pattern, 20 concentric, and 18 mixed. We found an association between concentric pattern and HER2+ (p < 0.001) and mixed pattern and Luminal A lesions (p < 0.001). We observed a statistical significant correlation between concentric pattern and complete response (p < 0.001) and between mixed pattern and non-response (p = 0.005). Enhancement intensity decrease 3 was associated with complete response (p < 0.001). Shrinkage pattern and enhancement intensity decrease may serve as early response indicators after neoadjuvant chemotherapy. Shrinkage pattern correlates with tumor biological subtypes.

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Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy

et al. 2017

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“…However, based on hormonal or histopathological changes, the uptake of contrast in breast MRI could vary [19]. We have previously reported that breast MRI in triple-negative breast cancer is helpful for determining the surgical plan [14].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of breast MRI for surgical decision in patients with breast cancer: ductal carcinoma in situ versus invasive ductal carcinoma

et al. 2020

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Background Preoperative breast magnetic resonance imaging (MRI) provides more information than mammography and ultrasonography for determining the surgical plan for patients with breast cancer. This study aimed to determine whether breast MRI is more useful for patients with ductal carcinoma in situ (DCIS) lesions than for those with invasive ductal carcinoma (IDC). Methods A total of 1113 patients with breast cancer underwent mammography, ultrasonography, and additional breast MRI before surgery. The patients were divided into 2 groups: DCIS (n = 199) and IDC (n = 914), and their clinicopathological characteristics and oncological outcomes were compared. Breast surgery was classified as follows: conventional breast-conserving surgery (Group 1), partial mastectomy with volume displacement (Group 2), partial mastectomy with volume replacement (Group 3), and total mastectomy with or without reconstruction (Group 4). The initial surgical plan (based on routine mammography and ultrasonography) and final surgical plan (after additional breast MRI) were compared between the 2 groups. The change in surgical plan was defined as group shifting between the initial and final surgical plans. Results Changes (both increasing and decreasing) in surgical plans were more common in the DCIS group than in the IDC group (P < 0.001). These changes may be attributed to the increased extent of suspicious lesions on breast MRI, detection of additional daughter nodules, multifocality or multicentricity, and suspicious findings on mammography or ultrasonography but benign findings on breast MRI. Furthermore, the positive margin incidence in frozen biopsy was not different (P = 0.138). Conclusions Preoperative breast MRI may provide more information for determining the surgical plan for patients with DCIS than for those with IDC.

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“…Next, the TICs from the selected region were averaged automatically. Based on visual observations with the naked eye, the mean curve was categorized as persistently enhancing (type I), plateau (type II), and washout (type III) 8 , 28 - 30 . The mean MSI value in the manually drawn region was determined automatically.…”

Section: Methodsmentioning

confidence: 99%

Discrimination between malignant and benign mass-like lesions from breast dynamic contrast enhanced MRI: semi-automatic vs. manual analysis of the signal time-intensity curves

Yin¹,

Yang²,

Jiang³

2018

J. Cancer

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Purpose: To investigate the performance of a new semi-automatic method for analyzing the signal time-intensity curve (TIC) obtained by breast dynamic contrast enhancement (DCE)-MRI.Methods: In the conventional method, a circular region of interest was drawn manually onto the map reflecting the maximum slope of increase (MSI) to delineate the suspicious lesions. The mean TIC was determined subjectively as one of three different wash-out patterns. In the new method, the lesion area was identified semi-automatically. The mean TIC was categorized quantitatively. In addition to the MSI, other quantitative parameters were calculated, including the signal intensity slope (SIslope), initial percentage of enhancement (Einitial), percentage of peak enhancement (Epeak), early signal enhancement ratio (ESER), and second enhancement percentage (SEP). The performances were compared with receiver operating characteristic (ROC) analysis and Wilcoxon's test.Results: For TIC categorization results, the diagnostic accuracy rates were 61.54% with the traditional manual method and 76.92% with the new method. For the mean MSI values from the manual method, the accuracy was 63.41%. For the mean TIC derived using the semi-automatic method, the diagnostic accuracy were 82.05% for SIslope, 67.31% for MSI, 61.53% for Einitial, 64.75% for Epeak, 64.74% for ESER, and 52.56% for SEP, respectively. For the lesion regions identified by the semi-automatic method, the diagnostic accuracy for above mentioned parameters were 80.13%, 69.87%, 61.54%, 63.47%, 64.74% and 55.13%, respectively.Conclusion: With respect to the analysis of TIC from breast DCE-MRI, the results demonstrated that the new method increased the diagnostic accuracy, and should be considered as a supplementary tool for distinguishing benign and malignant lesions.

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Magnetic Resonance in the Detection of Breast Cancers of Different Histological Types

Cited by 9 publications

References 123 publications

Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy

Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy

Efficacy of breast MRI for surgical decision in patients with breast cancer: ductal carcinoma in situ versus invasive ductal carcinoma

Discrimination between malignant and benign mass-like lesions from breast dynamic contrast enhanced MRI: semi-automatic vs. manual analysis of the signal time-intensity curves

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