Kim Jin You, Kim Jin Joo, Lee Ji Won, Lee Nam Kyung, Kim Suk, Nam Kyung Jin, Lee Kyeyoung, Choo Ki Seok
Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 179, Gudeok-Ro, Seo-Gu, Busan, 49241, Republic of Korea.
Department of Radiology, Biomedical Research Institute, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, Republic of Korea.
Radiol Med. 2024 Dec;129(12):1790-1801. doi: 10.1007/s11547-024-01914-8. Epub 2024 Nov 4.
To evaluate whether breast parenchymal features of the contralateral breast on preoperative MRI are associated with primary breast cancer characteristics and disease-free survival (DFS) in women with invasive breast cancer.
Women with newly diagnosed invasive breast cancer who underwent preoperative breast MRI followed by surgery were retrospectively evaluated. Background parenchymal enhancement (BPE) on dynamic contrast-enhanced MRI and background diffusion signal (BDS) on diffusion-weighted MRI of the contralateral breast were qualitatively assessed using a four-category scale: minimal, mild, moderate, or marked. Primary breast cancer characteristics were compared based on the degree of BPE or BDS. Cox proportional hazards models were used to evaluate the association between MRI parenchymal features and DFS after adjusting for clinicopathologic features.
A total of 515 women (mean age, 54 years) were included. Of whom, 46 (8.9%) patients who developed disease recurrence at a median follow-up of 60 months were observed. A high level (moderate/marked) of BPE or BDS was associated with younger age (≤ 45) and premenopausal status (all P < 0.05) compared to a low level (minimal/mild), but it was not associated with primary cancer characteristics such as tumor stage, grade, or subtype. Multivariable Cox proportional hazards analysis demonstrated that larger tumor size (> 2 cm) (hazard ratio [HR], 3.877; P < . 001), triple-negative subtype (HR, 2.440; P = .013), and axillary node metastasis (HR, 1.823; P = .049) were associated with worse DFS. No associations were observed between background parenchymal features and disease outcomes.
MRI parenchymal features, including BPE and BDS, of the contralateral breast showed no associations with primary breast cancer characteristics or DFS in women with invasive breast cancer.
评估术前MRI检查时对侧乳腺的实质特征是否与浸润性乳腺癌女性的原发性乳腺癌特征及无病生存期（DFS）相关。
对新诊断为浸润性乳腺癌且术前行乳腺MRI检查并随后接受手术的女性进行回顾性评估。采用四级量表对动态对比增强MRI上的背景实质强化（BPE）和对侧乳腺扩散加权MRI上的背景扩散信号（BDS）进行定性评估：最小、轻度、中度或显著。根据BPE或BDS程度比较原发性乳腺癌特征。在调整临床病理特征后，使用Cox比例风险模型评估MRI实质特征与DFS之间的关联。
共纳入515名女性（平均年龄54岁）。其中，在中位随访60个月时观察到46名（8.9%）患者出现疾病复发。与低水平（最小/轻度）相比，高水平（中度/显著）的BPE或BDS与较年轻年龄（≤45岁）和绝经前状态相关（所有P＜0.05），但与肿瘤分期、分级或亚型等原发性癌症特征无关。多变量Cox比例风险分析表明，肿瘤较大（＞2cm）（风险比[HR]，3.877；P＜0.001）、三阴性亚型（HR，2.440；P = 0.013）和腋窝淋巴结转移（HR，1.823；P = 0.049）与较差的DFS相关。未观察到背景实质特征与疾病结局之间的关联。
浸润性乳腺癌女性对侧乳腺的MRI实质特征，包括BPE和BDS，与原发性乳腺癌特征或DFS无关。
