Dynamic contrast-enhanced breast magnetic resonance imaging for the prediction of early and late recurrences in breast cancer

Choi, Eun Jung; Choi, Hyemi; Choi, Seung-Hee; Youk, Ji Hyun

doi:10.1097/md.0000000000005330

Cited by 30 publications

(31 citation statements)

References 29 publications

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“…Also, increased vascularity always showed significant association with disease recurrence in every multivariable model. Increased vascularity due to the tumor can affect other MRI parameters related to tumor vascularity, including perfusion or texture parameters 13,19 . However, texture and perfusion parameters were associated with disease recurrence independent of increased ipsilateral vascularity in present study.…”

Section: Discussionmentioning

confidence: 99%

“…Breast MRI is performed in most patients with newly diagnosed breast cancer and can both diagnose breast cancer accurately and predict cancer prognosis using variable imaging features. Previous studies identified that several imaging features including rim enhancement pattern of tumor 13,14 , presence of peritumoral edema on T2-weighted image 15,16 , higher degree of background parenchymal enhancement (BPE), and increased vascularity around the tumor, indicate poor prognosis in breast cancer [13][14][15][16][17] . In addition to morphologic features of tumor, quantitative MRI parameters derived from advanced MR techniques have been recently developed for prediction of breast cancer prognosis.…”

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confidence: 99%

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Prognostic Factors of Disease Recurrence in Breast Cancer Using Quantitative and Qualitative Magnetic Resonance Imaging (MRI) Parameters

Lee

Kim

Kang

2020

Sci Rep

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the purpose of this study was to investigate prognostic factors predicting recurrence of breast cancer, focusing on imaging factors including morphologic features, quantitative MR parameters, and clinicopathologic factors. this retrospective study was approved by our institutional review board, and the requirement to obtain informed consent was waived. A total of 267 patients with breast cancer were enrolled in this study, who underwent dynamic contrast-enhanced magnetic resonance imaging (MRi) before surgery from February 2014 to June 2016. Imaging parameters of MRI, including morphologic features, perfusion parameters, and texture analysis, were retrospectively reviewed by two expert breast radiologists. clinicopathologic information of enrolled patients was also reviewed using medical records. Univariable and multivariable cox proportional hazards regression analyses were used to identify factors associated with cancer recurrence. c statistics was used to discriminate low and high risk patients for disease recurrence. Using Kaplan-Meier survival analysis, disease-free survival was compared between patients who experienced recurrence and those who did not. At a median follow up of 49 months, 32 patients (12%) showed disease: six cases of ipsilateral breast or axilla recurrence, one case of contralateral breast recurrence, 24 cases of distant metastasis, and one case of both ipsilateral breast recurrence and distant metastasis. of multiple imaging features and parameters, increased ipsilateral vascularity and higher positive skewness of texture analysis showed significant association with disease recurrence in every multivariable model regardless of tumor subtype and pathologic stage. Pathologic stage, especially if higher than stage II, showed significant association with disease recurrence and its highest hazard ratio was 3.45 [95% confidence interval (CI): 1.37-8.67, p = 0.008]. of the multivariable models, the model including clinico-pathologic factors and both qualitative and quantitative imaging parameters showed good discrimination with a high C index value of 0.825 (95% CI: 0.755-0.896). In addition, recurrence associated factors were associated with short interval time to disease recurrence by Kaplan-Meier survival analysis. therefore, comprehensive analysis using both clinico-pathologic factors and qualitative and quantitative imaging parameters is more effective in predicting breast cancer recurrence. Among those factors, higher pathologic stage, increased ipsilateral vascularity and higher positive skewness of texture analysis could be good predictors of breast cancer recurrence. Moreover, when these three factors are applied comprehensively, they may also be the predictors for poor survival. Breast cancer is a leading cause of death among women worldwide and the second most common cancer in Korean women. However, with increased screening and development of treatment methods, breast cancer mortality rates have improved over the last few decades 1,2. Postoperative adjuvant systemic therapies including...

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Prognostic Factors of Disease Recurrence in Breast Cancer Using Quantitative and Qualitative Magnetic Resonance Imaging (MRI) Parameters

Lee

Kim

Kang

2020

Sci Rep

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“…Nonmass enhancement was defined as the enhancement of an area that was not a mass, whose internal enhancement characteristics were discrete from the normal surrounding breast parenchyma. In addition, the presence of peritumoral edema and the pattern of tumor shrinkage (concentric or nonconcentric) were also evaluated because these findings have been reported to show an association with LRR (17,(22)(23)(24) or distant metastasis (25). The presence of peritumoral edema was defined when high signal intensity around the tumor or posterior to the tumor mass in the prepectoral area was observed on T2-weighted images (26).…”

Section: Clinical-pathologic and Mr Image Feature Analysismentioning

confidence: 99%

Neoadjuvant Chemotherapy and Surgery for Breast Cancer: Preoperative MRI Features Associated with Local Recurrence

et al. 2018

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Purpose To investigate the MRI and clinical-pathologic features associated with local-regional recurrence (LRR) in patients who had undergone breast-conserving surgery (BCS) following neoadjuvant chemotherapy (NAC). Materials and Methods In this retrospective, single-institution study between October 2003 and September 2015, 548 consecutive women, consisting of 468 down-staged and 80 preplanned BCS patients (mean age, 45.7 years; range, 22-75 years), underwent preoperative MRI and BCS following NAC. The rate and site of LRR, preoperative MRI features including Breast Imaging Reporting and Data System lexicon, and clinical-pathologic features (age, stage, tumor subtype, histologic grade, lymphovascular invasion, adjuvant chemotherapy, and endocrine therapy) were analyzed with the Cox proportional hazards model to identify independent factors associated with LRR-free survival (LRFS). Results Of the 548 women, 23 (4.2%) had LRR at a median follow-up of 23.1 months. In Cox regression analysis, younger age (ie, ≤ 40 years) (hazard ratio = 2.932; 95% confidence interval [CI]: 1.233, 6.969; P = .015) or the presence of nonmass enhancement on preoperative MR images (hazard ratio = 3.220; 95% CI: 1.274, 8.140; P = .014) was associated with worse LRFS. LRR was more frequently observed in the same quadrant as the original tumor in the down-staged BCS group than in the preplanned BCS group (80.0% [16 of 20] vs 33.3% [one of three]; P = .021). Conclusion Age of 40 years or younger or the presence of nonmass enhancement on preoperative MR images tends to be associated with worse local-regional recurrence-free survival, and local-regional recurrence frequently occurs in the same quadrant as the original tumor in breast cancer patients who undergo breast-conserving surgery following neoadjuvant chemotherapy. © RSNA, 2018.

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“…Contrast-enhanced breast magnetic resonance imaging (MRI) is an ideal imaging modality that helps in representing tumour angiogenesis. In MRI, the contrast enhanced pattern of the tumour correlates to the micro-vessels density which is a characteristic of tumour angiogenesis [8]. The features of dynamic contrast-enhanced MRI (DCE-MRI) such as washout curve type, peripheral rim enhancement, and faster enhancement are correlated with overall survival and recurrence of breast cancer patients [8].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Magnetic Resonance Imaging in BIRADS 3, 4 and 5 Patients Detected on Full Filed Digital Mammography: Our Experience

Patil¹,

Pawar²,

Nagarkar³

et al. 2019

OJCD

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Aim of the study: To perform Dynamic contrast enhanced MRI of breast in patients with positive findings (BIRADS 3, 4 and 5) detected on screening mammography; to correlate the findings of digital mammography and contrast enhanced MRI of breast with histopathological examinations. Settings and Design: A prospective observation study was conducted at a single centre, i.e. HCG Manavata Cancer Centre. Materials and Methods: Screening mammography was performed on patients with age > 40 years and on patients with age 35-40 years having positive family history. The positive mammography was reported and the lesions classified according to BIRADS criteria for mammography. Results: Mammographic examination of the breast lesions yielded an overall sensitivity of 97.67% and a specificity of 85.71%. In our study we combined both morphologic and dynamic parameters and its modification into BIRADS category for lesion classification. The sensitivity of MRI examinations was 97.67% while the specificity was 71.43%. Spiculated margins were encountered only in malignant lesions (p = 0.0006). Statistical correlation was obtained between the pathologically proven benign and malignant lesions regarding their enhancement pattern with p value of <0.001. Conclusion: As per the results, dynamic contrast MRI had high sensitivity but limited specificity. We did not find any significant difference between FFDM and MRI in terms of diagnostic accuracy. The use of DWI showed high specificity at cut off point of ADC value-0.85 mm 2 /s. Thus, DWI can be used in addition of morphological and dynamic kinetic characteristics to increase specificity of MRI.

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Dynamic contrast-enhanced breast magnetic resonance imaging for the prediction of early and late recurrences in breast cancer

Cited by 30 publications

References 29 publications

Prognostic Factors of Disease Recurrence in Breast Cancer Using Quantitative and Qualitative Magnetic Resonance Imaging (MRI) Parameters

Prognostic Factors of Disease Recurrence in Breast Cancer Using Quantitative and Qualitative Magnetic Resonance Imaging (MRI) Parameters

Neoadjuvant Chemotherapy and Surgery for Breast Cancer: Preoperative MRI Features Associated with Local Recurrence

Efficacy of Magnetic Resonance Imaging in BIRADS 3, 4 and 5 Patients Detected on Full Filed Digital Mammography: Our Experience

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