Early-stage invasive ductal carcinoma: Association of tumor apparent diffusion coefficient values with axillary lymph node metastasis

Kim, Jin Joo; Seo, Hie Bum; Park, Shinyoung; Moon, Jin Il; Lee, Ji Won; Lee, Nam Kyung; Lee, Seok Won; Bae, Young Tae

doi:10.1016/j.ejrad.2015.08.009

Cited by 24 publications

(20 citation statements)

References 29 publications

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“…Evaluating the status of axillary lymph nodes (ALNs) is essential in deciding appropriate treatment and staging as well as predicting the long-term survival in breast cancer [3]. Although significant progress has been made in the genetic and molecular characterization of breast malignant lesions, axillary lymph node involvement is the single most important prognostic variable [4–7]. …”

Section: Introductionmentioning

confidence: 99%

BI-RADS 3-5 microcalcifications: prediction of lymph node metastasis of breast cancer

et al. 2017

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PurposeTo determine whether the clinicopathological parameters and Breast Imaging Reporting and Data System (BI-RADS) 3–5 microcalcifications differed between lymph node positive (LN (+)) and lymph node negative (LN (−)) invasive ductal carcinoma (IDC).ResultsFor microcalcification-associated breast cancers, seven selected features (age, tumor size, Ki-67 status, lymphovascular invasion, calcification range, calcification diameter and calcification density) were significantly associated with LN status (all P < 0.05). Multivariate logistic regression analysis found that three risk factors (age: older vs. younger OR: 0.973 P = 0.006, tumor size: larger vs. smaller OR: 1.671, P < 0.001 and calcification density: calcifications > 20/cm2 vs. calcifications ≤ 20/cm2 OR: 1.698, P < 0.001) were significant independent predictors. This model had an area under the receiver operating characteristic curve (AUC) of 0.701. The nodal staging (N0 and N1 χ2 = 5.701, P = 0.017; N0 and N2 χ2 = 6.614, P = 0.013) was significantly positively associated with calcification density. The luminal B subtype had the highest risk of LN metastasis. Multivariate analysis demonstrated that calcification > 2 cm in range (OR: 2.209) and larger tumor size (OR: 1.882) were independently predictive of LN metastasis in the luminal B subtype (AUC = 0.667).Materials and MethodsMammographic images of 419 female breast cancer patients were included. Associations between the risk factors and LN status were evaluated using a Chi-square test, ANOVA and binary logistic regression analysis.ConclusionsThis study found that age, tumor size and calcifications density can be conveniently used to facilitate the preoperative prediction of LN metastasis. The luminal B subtype has the highest risk of LN metastasis among the microcalcification-associated breast cancers.

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Section: Introductionmentioning

confidence: 99%

BI-RADS 3-5 microcalcifications: prediction of lymph node metastasis of breast cancer

et al. 2017

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“…Using such data, recent studies have focused on identifying MRI biomarkers that predict breast cancer prognosis. Earlier reports have shown that the ADC is associated with well‐established prognostic factors, including tumor size, histological grade, axillary lymph node status, and hormone receptor status . Furthermore, Mori et al recently found a significant correlation between the ADC and Ki‐67 status, which also predicts outcomes, in patients with luminal‐type breast cancer.…”

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confidence: 96%

“…Earlier reports have shown that the ADC is associated with well-established prognostic factors, including tumor size, histological grade, axillary lymph node status, and hormone receptor status. 11,12 Furthermore, Mori et al 13 recently found a significant correlation between the ADC and Ki-67 status, which also predicts outcomes, in patients with luminal-type breast cancer. However, the results of previous studies on the relationships between perfusion parameters derived from DCE-MRI and prognostic factors (especially the Ki-67 index) have been inconsistent.…”

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confidence: 98%

Dynamic contrast-enhanced and diffusion-weighted MRI of estrogen receptor-positive invasive breast cancers: Associations between quantitative MR parameters and Ki-67 proliferation status

Shin

Kim

2016

J. Magn. Reson. Imaging

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“…Several studies have compared diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values on MRI with various pathological findings and biomarkers of breast cancer [11][12][13][14]. Several reports showed that the ADC values of breast lesions in patients with positive axillary LN metastasis were significantly lower than those with negative axillary LN metastasis [14][15][16]. In these previous studies, the mean ADC values of the lesion were used in the evaluations [11][12][13][14][15][16], however, the usefulness of the minimum ADC value was recently recognized for differentiating between malignant and benign breast masses [17], detecting invasive components in ductal carcinoma in situ [18], and distinguishing breast cancer subtypes [19].…”

Section: Introductionmentioning

confidence: 99%

“…Several reports showed that the ADC values of breast lesions in patients with positive axillary LN metastasis were significantly lower than those with negative axillary LN metastasis [14][15][16]. In these previous studies, the mean ADC values of the lesion were used in the evaluations [11][12][13][14][15][16], however, the usefulness of the minimum ADC value was recently recognized for differentiating between malignant and benign breast masses [17], detecting invasive components in ductal carcinoma in situ [18], and distinguishing breast cancer subtypes [19]. According to Hirano et al, sensitivity and specificity of the minimum ADC values were higher than those of the mean ADC values for the differentiation of benign and malignant breast lesions [17].…”

Section: Introductionmentioning

confidence: 99%

Predicting metastasis in clinically negative axillary lymph nodes with minimum apparent diffusion coefficient value in luminal A-like breast cancer

et al. 2019

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Background: We investigated the usefulness of the minimum ADC value of primary breast lesions for predicting axillary lymph node (LN) status in luminal Alike breast cancers with clinically negative nodes in comparison with the mean ADC. Methods: Forty-four luminal Alike breast cancers without axillary LN metastasis at preoperative clinical evaluation, surgically resected with sentinel LN biopsy, were retrospectively studied. Mean and minimum ADC values of each lesion were measured and statistically compared between LN-positive (n = 12) and LN-negative (n = 32) groups. An ROC curve was drawn to determine the best cutoff value to differentiate LN status. Correlations between mean and minimum ADC values and the number of metastatic axillary LNs were investigated. Results: Mean and minimum ADC values of breast lesions with positive LN were significantly lower than those with negative LN (mean: 839.9 ± 110.9 vs. 1022.2 ± 250.0 × 10-6 mm 2 /s, p = 0.027, minimum: 696.7 ± 128.0 vs. 925.0 ± 257.6 × 10-6 mm 2 /s, p = 0.004). The sensitivity and NPV using the best cutoff value from ROC using both mean and minimum ADC were 100%. AUC of the minimum ADC (0.784) was higher than that of the mean ADC (0.719). Statistically significant negative correlations were observed between both mean and minimum ADCs and number of positive LNs, with p. 2 stronger correlation to minimum ADC than mean ADC. Conclusions: The minimum ADC value of primary breast lesions predicts axillary LN metastasis in luminal Alike breast cancer with clinically negative nodes, with high sensitivity and high NPV.

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Early-stage invasive ductal carcinoma: Association of tumor apparent diffusion coefficient values with axillary lymph node metastasis

Cited by 24 publications

References 29 publications

BI-RADS 3-5 microcalcifications: prediction of lymph node metastasis of breast cancer

BI-RADS 3-5 microcalcifications: prediction of lymph node metastasis of breast cancer

Dynamic contrast-enhanced and diffusion-weighted MRI of estrogen receptor-positive invasive breast cancers: Associations between quantitative MR parameters and Ki-67 proliferation status

Predicting metastasis in clinically negative axillary lymph nodes with minimum apparent diffusion coefficient value in luminal A-like breast cancer

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