Imaging Department, Graduate Program of A.C.Camargo Cancer Center, São Paulo, SP, Brazil.
Imaging Department, A Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
Sci Rep. 2024 Aug 20;14(1):19305. doi: 10.1038/s41598-024-69778-6.
To compare the magnetic resonance imaging (MRI) features of different immunophenotypes of breast carcinoma of no special type (NST), with special attention to estrogen receptor (ER)-low-positive breast cancer. This retrospective, single-centre, Institutional Review Board (IRB)-approved study included 398 patients with invasive breast carcinoma. Breast carcinomas were classified as ER-low-positive when there was ER staining in 1-10% of tumour cells. Pretreatment MRI was reviewed to assess the tumour imaging features according to the 5th edition of the Breast Imaging Reporting and Data System (BI-RADS) lexicon. Of the 398 cases, 50 (12.6%) were luminal A, 191 (48.0%) were luminal B, 26 (6.5%) were luminal ER-low positive, 64 (16.1%) were HER2-overexpressing, and 67 (16.8%) were triple negative. Correlation analysis between MRI features and tumour immunophenotype showed statistically significant differences in mass shape, margins, internal enhancement and the delayed phase of the kinetic curve. An oval or round shape and rim enhancement were most frequently observed in triple-negative and luminal ER-low-positive tumours. Spiculated margins were most common in luminal A and luminal B tumours. A persistent kinetic curve was more frequent in luminal A tumours, while a washout curve was more common in the triple-negative, HER2-overexpressing and luminal ER-low-positive immunophenotypes. Multinomial regression analysis showed that luminal ER-low-positive tumours had similar results to triple-negative tumours for almost all variables. Luminal ER-low-positive tumours present with similar MRI findings to triple-negative tumours, which suggests that MRI can play a fundamental role in adequate radiopathological correlation and therapeutic planning in these patients.
比较不同免疫表型非特殊型（NST）乳腺癌的磁共振成像（MRI）特征，尤其关注雌激素受体（ER）低阳性乳腺癌。本回顾性单中心研究获得机构审查委员会（IRB）批准，共纳入 398 例浸润性乳腺癌患者。当肿瘤细胞中 ER 染色为 1-10%时，将乳腺癌归类为 ER 低阳性。评估术前 MRI，根据第 5 版乳腺影像报告和数据系统（BI-RADS）词汇表评估肿瘤成像特征。398 例患者中， luminal A 型 50 例（12.6%），luminal B 型 191 例（48.0%），luminal ER 低阳性型 26 例（6.5%），HER2 过表达型 64 例（16.1%），三阴性型 67 例（16.8%）。MRI 特征与肿瘤免疫表型相关性分析显示，肿块形态、边界、内部强化和动力学曲线延迟期等方面存在统计学差异。三阴性和 luminal ER 低阳性肿瘤多表现为椭圆形或圆形，边缘强化。边缘呈毛刺状最常见于 luminal A 和 luminal B 肿瘤。luminal A 肿瘤中持续的动力学曲线更为常见，而三阴性、HER2 过表达和 luminal ER 低阳性免疫表型中则更常见廓清曲线。多变量回归分析显示，luminal ER 低阳性肿瘤与三阴性肿瘤在几乎所有变量方面的结果相似。luminal ER 低阳性肿瘤与三阴性肿瘤具有相似的 MRI 表现，这提示 MRI 可以在这些患者的充分放射病理相关性和治疗计划中发挥重要作用。
