Kaiser Clemens G, Herold Michael, Krammer Julia, Baltzer Pascal, Gajda Mieczyslaw, Camara Oumar, Schoenberg Stefan, Kaiser Werner A, Dietzel Matthias
Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Mannheim, Germany.
Institute of Diagnostic and Interventional Radiology I, Friedrich-Schiller-University Hospital Jena, Jena, Germany.
Anticancer Res. 2017 Apr;37(4):1989-1995. doi: 10.21873/anticanres.11542.
BACKGROUND/AIM: Previous studies have indicated a highly significant correlation between invasive tumors and accompanying prepectoral edema (PE) in MR-mammography (MRM). The aim of the present study was to identify prognostic factors associated with PE as a diagnostic sign.
A total of 1,109 consecutive MRM exams were included in this study. Exclusion criteria were previous operation, biopsy, intervention, chemotherapy, hormone replacement therapy (HRT) or previous mastitis. One hundred and sixty-two patients with 180 lesions were evaluated and histologically correlated. Diagnostic evaluations were performed by four experienced radiologists in consensus.
One hundred and eighty lesions included 104 malignant lesions (93 invasive and 11 non-invasive) and 76 benign lesions. PE was detected significantly more frequently in presence of lymphangiosis carcinomatosa ((53.8%; 14/26) vs. (9.8%; 4/41)) (p<0,000). PE significantly correlates with positive axillary nodal status ((19.4% (12/62) vs. 44.4% (12/27)) (p=0.020), as well as pathologic enhancement of the pectoral muscle (5.4% (5/93) vs. 22.7% (20/88)) (p=0,015). PE significantly correlates with higher tumor grading (G3) (33.9% vs. 13.9%) (p<0.05). There was no significant difference in a positive vs. negative estrogen (p=0.681) and progesterone (p=0.751) and/or human epidermal growth factor receptor-2 (HER-2) (p=0.726) receptor status accompanied by PE.
The presence of PE may be a strong prognostic indicator for lymphatic spread and the cancerous infiltration of lymph nodes. It is also associated with the infiltration of the pectoral muscle, as well as high tumor grading. There is no correlation between prepectoral edema and positive tumor receptor status.
背景/目的：先前的研究表明，在乳腺磁共振成像（MRM）中，浸润性肿瘤与伴发的胸前区水肿（PE）之间存在高度显著的相关性。本研究的目的是确定与作为诊断标志的PE相关的预后因素。
本研究共纳入1109例连续的MRM检查。排除标准为既往手术、活检、干预、化疗、激素替代疗法（HRT）或既往乳腺炎。对162例有180个病灶的患者进行了评估，并进行了组织学相关性分析。由四位经验丰富的放射科医生达成共识进行诊断评估。
180个病灶包括104个恶性病灶（93个浸润性和11个非浸润性）和76个良性病灶。在存在癌性淋巴管炎的情况下，PE的检出率显著更高（（53.8%；14/26）对（9.8%；4/41））（p<0.000）。PE与腋窝淋巴结阳性状态显著相关（（19.4%（12/62）对44.4%（12/27））（p=0.020），以及胸肌的病理强化（5.4%（5/93）对22.7%（20/88））（p=0.015）。PE与较高的肿瘤分级（G3）显著相关（33.9%对13.9%）（p<0.05）。伴有PE的雌激素（p=0.681）、孕激素（p=0.751）和/或人表皮生长因子受体2（HER-2）（p=0.726）受体状态阳性与阴性之间无显著差异。
PE的存在可能是淋巴转移和淋巴结癌浸润的一个强有力的预后指标。它还与胸肌浸润以及高肿瘤分级相关。胸前区水肿与肿瘤受体阳性状态之间无相关性。
