Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Korea.
Department of Diagnostic Radiology, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea.
Korean J Radiol. 2018 Sep-Oct;19(5):897-904. doi: 10.3348/kjr.2018.19.5.897. Epub 2018 Aug 6.
To determine which preoperative breast magnetic resonance imaging (MRI) findings and clinicopathologic features are associated with positive resection margins at the time of breast-conserving surgery (BCS) in patients with breast cancer.
We reviewed preoperative breast MRI and clinicopathologic features of 120 patients (mean age, 53.3 years; age range, 27-79 years) with breast cancer who had undergone BCS in 2015. Tumor size on MRI, multifocality, patterns of enhancing lesions (mass without non-mass enhancement [NME] vs. NME with or without mass), mass characteristics (shape, margin, internal enhancement characteristics), NME (distribution, internal enhancement patterns), and breast parenchymal enhancement (BPE; weak, strong) were analyzed. We also evaluated age, tumor size, histology, lymphovascular invasion, T stage, N stage, and hormonal receptors. Univariate and multivariate logistic regression analyses were used to determine the correlation between clinicopathological features, MRI findings, and positive resection margins.
In univariate analysis, tumor size on MRI, multifocality, NME with or without mass, and segmental distribution of NME were correlated with positive resection margins. Among the clinicopathological factors, tumor size of the invasive breast cancer and components were significantly correlated with a positive resection margin. Multivariate analysis revealed that NME with or without mass was an independent predictor of positive resection margins (odds ratio [OR] = 7.00; < 0.001). Strong BPE was a weak predictor of positive resection margins (OR = 2.59; = 0.076).
Non-mass enhancement with or without mass is significantly associated with a positive resection margin in patients with breast cancer. In patients with NME, segmental distribution was significantly correlated with positive resection margins.
确定乳腺癌患者保乳手术（BCS）时与切缘阳性相关的术前乳腺磁共振成像（MRI）表现和临床病理特征。
我们回顾了 2015 年接受 BCS 的 120 例乳腺癌患者的术前乳腺 MRI 和临床病理特征（平均年龄 53.3 岁；年龄范围 27-79 岁）。分析了 MRI 上的肿瘤大小、多灶性、强化病变模式（无非肿块强化的肿块与有或无肿块的非肿块强化）、肿块特征（形状、边界、内部强化特征）、非肿块强化（分布、内部强化模式）和乳腺实质强化（弱、强）。我们还评估了年龄、肿瘤大小、组织学、脉管侵犯、T 分期、N 分期和激素受体。采用单因素和多因素逻辑回归分析来确定临床病理特征、MRI 表现与切缘阳性之间的相关性。
单因素分析显示，MRI 上的肿瘤大小、多灶性、有或无肿块的非肿块强化以及非肿块强化的节段性分布与切缘阳性相关。在临床病理因素中，浸润性乳腺癌和 成分的肿瘤大小与切缘阳性显著相关。多因素分析显示，有或无肿块的非肿块强化是切缘阳性的独立预测因子（比值比[OR] = 7.00； < 0.001）。强乳腺实质强化是切缘阳性的弱预测因子（OR = 2.59； = 0.076）。
乳腺癌患者有或无肿块的非肿块强化与切缘阳性显著相关。在有非肿块强化的患者中，节段性分布与切缘阳性显著相关。
