Department of Radiology and Medical Imaging, "Iuliu Hatieganu" University of Medicine and Pharmacy, 400374 Cluj-Napoca, Romania.
Medicina (Kaunas). 2022 Nov 23;58(12):1716. doi: 10.3390/medicina58121716.
Background and Objectives: Breast cancer (BC) molecular subtypes have unique incidence, survival and response to therapy. There are five BC subtypes described by immunohistochemistry: luminal A, luminal B HER2 positive and HER2 negative, triple negative (TNBC) and HER2-enriched. Multiparametric breast MRI (magnetic resonance imaging) provides morphological and functional characteristics of breast tumours and is nowadays recommended in the preoperative setting. Aim: To evaluate the multiparametric MRI features (T2-WI, ADC values and DCE) of breast tumours along with breast density and background parenchymal enhancement (BPE) features among different BC molecular subtypes. Materials and Methods: This was a retrospective study which included 344 patients. All underwent multiparametric breast MRI (T2WI, ADC and DCE sequences) and features were extracted according to the latest BIRADS lexicon. The inter-reader agreement was assessed using the intraclass coefficient (ICC) between the ROI of ADC obtained from the two breast imagers (experienced and moderately experienced). Results: The study population was divided as follows: 89 (26%) with luminal A, 39 (11.5%) luminal B HER2 positive, 168 (48.5%) luminal B HER2 negative, 41 (12%) triple negative (TNBC) and 7 (2%) with HER2 enriched. Luminal A tumours were associated with special histology type, smallest tumour size and persistent kinetic curve (all p-values < 0.05). Luminal B HER2 negative tumours were associated with lowest ADC value (0.77 × 10−3 mm2/s2), which predicts the BC molecular subtype with an accuracy of 0.583. TNBC were associated with asymmetric and moderate/marked BPE, round/oval masses with circumscribed margins and rim enhancement (all p-values < 0.05). HER2 enriched BC were associated with the largest tumour size (mean 37.28 mm, p-value = 0.02). Conclusions: BC molecular subtypes can be associated with T2WI, ADC and DCE MRI features. ADC can help predict the luminal B HER2 negative cases.
背景与目的：乳腺癌（BC）分子亚型具有独特的发病、生存和治疗反应。免疫组织化学可将 BC 分为五种亚型：Luminal A、Luminal B（HER2 阳性和 HER2 阴性）、三阴性（TNBC）和 HER2 富集型。多参数乳腺 MRI（磁共振成像）提供了乳腺肿瘤的形态和功能特征，目前推荐在术前使用。目的：评估不同 BC 分子亚型的乳腺肿瘤的多参数 MRI 特征（T2-WI、ADC 值和 DCE）以及乳腺密度和背景实质增强（BPE）特征。材料与方法：这是一项回顾性研究，共纳入 344 例患者。所有患者均行多参数乳腺 MRI（T2WI、ADC 和 DCE 序列）检查，并根据最新的 BIRADS 词汇表提取特征。采用两位乳腺成像医师（经验丰富和经验中等）获得的 ADC ROI 的组内相关系数（ICC）评估读者间的一致性。结果：研究人群分为以下几类：89 例（26%）为 Luminal A 型，39 例（11.5%）为 Luminal B（HER2 阳性），168 例（48.5%）为 Luminal B（HER2 阴性），41 例（12%）为三阴性（TNBC），7 例（2%）为 HER2 富集型。Luminal A 型肿瘤与特殊组织学类型、最小肿瘤大小和持续动力学曲线有关（所有 p 值均<0.05）。Luminal B（HER2 阴性）肿瘤的 ADC 值最低（0.77×10−3mm2/s2），预测 BC 分子亚型的准确率为 0.583。TNBC 与不对称和中度/显著 BPE、圆形/椭圆形肿块、边界清晰的边缘和边缘增强有关（所有 p 值均<0.05）。HER2 富集型 BC 与最大肿瘤大小有关（平均 37.28mm，p 值=0.02）。结论：BC 分子亚型与 T2WI、ADC 和 DCE MRI 特征相关。ADC 有助于预测 Luminal B（HER2 阴性）病例。
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