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阴性乳腺磁共振成像后第二乳腺癌:基于手术间隔和危险因素的分析。

Second breast cancer following negative breast MRI: Analysis by interval from surgery and risk factors.

机构信息

Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

PLoS One. 2024 Aug 15;19(8):e0306828. doi: 10.1371/journal.pone.0306828. eCollection 2024.

Abstract

OBJECTIVES

This study aims to compare outcomes following a negative surveillance MRI study by surgery-MRI interval and investigate factors associated with second breast cancers in women with a personal history of breast cancer (PHBC).

METHODS

This retrospective study included 1552 consecutive women (mean age, 53 years) with a PHBC and a negative prevalence surveillance breast MRI result between August 2014 and December 2016. The incidence and characteristics of second breast cancers were reviewed and compared according to surgery-MRI interval (< 3 years vs ≥ 3 years). Logistic regression analysis was used to investigate associations with clinical-pathologic characteristics.

RESULTS

Twenty-five second breast cancers occurred after negative MRI. The incidence of second breast cancers or local-regional recurrence did not significantly differ by surgery-MRI interval. The median intervals between MRI to second breast cancer detection showed no significant difference between the two groups (surgery-MRI interval <3 years vs. ≥ 3 years). Two node-positive second breast cancers were detected in the group with <3 years interval. BRCA mutation status, receipt of breast-conserving surgery, and adjuvant chemotherapy (all p < .05) were significant factors associated with the development of second breast cancers.

CONCLUSION

Outcomes following a negative surveillance MRI did not differ by surgery-MRI interval. BRCA mutation status, receipt of breast-conserving surgery and adjuvant chemotherapy were independently associated with the risk of developing second breast cancers after negative surveillance MRI.

摘要

目的

本研究旨在比较手术-磁共振成像(MRI)间隔时间对阴性监测 MRI 研究后结局的影响,并探讨与乳腺癌个人史(PHBC)女性中第二乳腺癌相关的因素。

方法

本回顾性研究纳入了 1552 例连续 PHBC 女性(平均年龄 53 岁),她们在 2014 年 8 月至 2016 年 12 月期间进行了阴性预发性乳腺 MRI 监测。根据手术-MRI 间隔时间(<3 年与≥3 年),回顾并比较了第二乳腺癌的发生率和特征。采用逻辑回归分析探讨与临床病理特征的关联。

结果

25 例女性在阴性 MRI 后发生了第二乳腺癌。手术-MRI 间隔时间对第二乳腺癌或局部区域复发的发生率无显著影响。两组之间 MRI 至第二乳腺癌检测的中位间隔时间无显著差异(手术-MRI 间隔时间<3 年与≥3 年)。在间隔时间<3 年的组中,检测到 2 例淋巴结阳性的第二乳腺癌。BRCA 基因突变状态、接受保乳手术和辅助化疗(均 p<0.05)是与第二乳腺癌发生相关的显著因素。

结论

阴性监测 MRI 后的结局与手术-MRI 间隔时间无关。BRCA 基因突变状态、接受保乳手术和辅助化疗是阴性监测 MRI 后发生第二乳腺癌的独立相关因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8681/11326552/97068427127a/pone.0306828.g001.jpg

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