Deniz Altıntaş Derya, Esen Icten Gul, Taşkın Füsun, Uras Cihan
Department of Radiology, Health Science University Diyarbakır Gazi Yaşargil Tranining and Research Hospital, 21070 Kayapınar, Diyarbakır, Türkiye.
Senology Research Institute, Acıbadem Mehmet Ali Aydınlar University, 34638 Maslak, İstanbul, Türkiye.
Diagnostics (Basel). 2025 May 22;15(11):1300. doi: 10.3390/diagnostics15111300.
To investigate the association between MRI features of primary breast cancers with axillary status, aiming to identify possible imaging biomarkers. Patients diagnosed with breast cancer between 2021 and 2023 in our clinic were retrospectively evaluated, and those that presented as mass lesions on preoperative MRI examinations (: 123) were included in the study. Patients with and without metastatic axillary lymph nodes (mALN) were compared in terms of breast density, background parenchymal enhancement, tumor size, location in the breast, distance from the skin, patient age, presence of edema, multiple foci, histopathological type and molecular subtype of tumors. In multifocal/multicentric cases, the largest lesion was taken into consideration. Prepectoral and subcutaneous edema were considered diffuse edema, while perilesional edema was considered focal edema. MannWhitney U/Student- test, Chi- square/Fischer Exact tests and logistic regression analysis were used for statistical analyses as appropriate. Axilla was positive in 88 patients. There was a statistically significant difference in terms of edema, age, molecular subtype, Ki-67 index, number of lesions, tumor size, and laterality between the two groups ( < 0.05). Univariate logistic regression analysis showed that all included variables were statistically significant ( < 0.05). Multivariate logistic regression analysis revealed that presence of edema (OR: 2.46 CI; 1.11-5.48, = 0.027) and multiple lesions (OR: 1.86 CI; 1.01-3.43, = 0.046) were significantly associated with mALN. There was no significant difference between peritumoral edema and diffuse edema. Our study showed a statistically significant relationship between the axillary status and the presence of edema and multiple tumoral lesions on MRI. These findings have a potential to serve as prognostic imaging biomarkers for predicting the presence of mALN. Further studies with larger case series are needed to support our findings.
为研究原发性乳腺癌的MRI特征与腋窝状态之间的关联，旨在识别可能的影像学生物标志物。对2021年至2023年期间在我院诊断为乳腺癌的患者进行回顾性评估，将术前MRI检查显示为肿块病变的患者（n = 123）纳入研究。比较有和无腋窝转移淋巴结（mALN）的患者在乳腺密度、背景实质强化、肿瘤大小、乳腺内位置、距皮肤距离、患者年龄、水肿情况、多发病灶、肿瘤的组织病理学类型和分子亚型等方面的差异。在多灶性/多中心性病例中，考虑最大的病变。胸肌前和皮下水肿被视为弥漫性水肿，而病灶周围水肿被视为局灶性水肿。根据情况分别采用曼-惠特尼U检验/学生t检验、卡方检验/费舍尔精确检验和逻辑回归分析进行统计分析。88例患者腋窝为阳性。两组在水肿、年龄、分子亚型、Ki-67指数、病灶数量、肿瘤大小和患侧等方面存在统计学显著差异（P < 0.05）。单因素逻辑回归分析显示，所有纳入变量均具有统计学显著性（P < 0.05）。多因素逻辑回归分析显示，水肿的存在（OR：2.46，CI：1.11 - 5.48，P = 0.027）和多发病灶（OR：1.86，CI：1.01 - 3.43，P = 0.046）与mALN显著相关。瘤周水肿和弥漫性水肿之间无显著差异。我们的研究显示，腋窝状态与MRI上水肿和多个肿瘤病灶的存在之间存在统计学显著关系。这些发现有可能作为预测mALN存在的预后影像学生物标志物。需要进一步开展更大病例系列的研究来支持我们的发现。
