Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York.
Breast J. 2013 Nov-Dec;19(6):643-9. doi: 10.1111/tbj.12182. Epub 2013 Sep 9.
Triple-negative (TN) breast cancers, which are associated with a more aggressive clinical course and poorer prognosis, often present with benign imaging features on mammography and ultrasound. The purpose of this study was to compare the magnetic resonance imaging features of TN breast cancers with estrogen (ER) and progesterone (PR) positive, human epidermal growth factor receptor (HER2) negative cancers. Retrospective review identified 140 patients with TN breast cancer who underwent a preoperative breast MRI between 2003 and 2008. Comparison was made to 181 patients with ER+/PR+/HER2- cancer. Breast MRIs were independently reviewed by two radiologists blinded to the pathology. Discrepancies were resolved by a third radiologist. TN cancers presented with a larger tumor size (p = 0.002), higher histologic grade (<0.001), and were more likely to be unifocal (p = 0.018) compared with ER+/PR+/HER2- tumors. MRI features associated with TN tumors included mass enhancement (p = 0.026), areas of intratumoral high T2 signal intensity (p < 0.001), lobulated shape (p < 0.001), rim enhancement (p < 0.001), and smooth margins (p = 0.005). Among the TN tumors with marked necrosis, 26% showed a large central acellular zone of necrosis.
三阴性（TN）乳腺癌与更具侵袭性的临床病程和较差的预后相关，其在乳房 X 线摄影和超声检查上通常表现出良性的影像学特征。本研究的目的是比较 TN 乳腺癌与雌激素（ER）和孕激素（PR）阳性、人表皮生长因子受体（HER2）阴性癌症的磁共振成像（MRI）特征。回顾性研究确定了 2003 年至 2008 年间进行术前乳房 MRI 的 140 例 TN 乳腺癌患者。将其与 181 例 ER+/PR+/HER2-癌症患者进行比较。两名放射科医生对乳房 MRI 进行独立审查，对病理结果不知情。出现分歧时，由第三位放射科医生进行裁决。与 ER+/PR+/HER2-肿瘤相比，TN 癌症的肿瘤大小更大（p = 0.002）、组织学分级更高（<0.001），并且更可能为单灶性（p = 0.018）。与 TN 肿瘤相关的 MRI 特征包括肿块强化（p = 0.026）、肿瘤内高 T2 信号强度区（p < 0.001）、分叶状形状（p < 0.001）、边缘强化（p < 0.001）和边缘光滑（p = 0.005）。在有明显坏死的 TN 肿瘤中，26%显示大的中央无细胞坏死区。
