Intra-tumoural lipid composition and lymphovascular invasion in breast cancer via non-invasive magnetic resonance spectroscopy

Abstract

Objectives Despite improved survival due to new treatments, the 10-year survival rate in patients with breast cancer is approximately 75%. Lymphovascular invasion (LVI), a prognostic marker independent from histological grade and stage, can only be fully determined at final histological examination. Lipid composition is deregulated in tumour via de novo lipogenesis, with alteration in lipogenic genes in LVI. We hypothesise alteration in lipid composition derived from novel non-invasive spectroscopy method is associated with LVI positivity. Methods Thirty female patients (age 39–78) with invasive ductal carcinoma were enrolled, with 13 LVI negative and 17 LVI positive. Saturated, monounsaturated, polyunsaturated fatty acids and triglycerides (SFA, MUFA, PUFA and TRG) were quantified from ex vivo breast tumours freshly excised from patients on a 3 T clinical MRI scanner, and proliferative activity marker Ki-67 and serotonin derived histologically. Results There were significantly lower MUFA (p = 0.0189) in LVI positive (median: 0.37, interquartile range (IQR): 0.25–0.64) than negative (0.63, 0.49–0.96). There were significantly lower TRG (p = 0.0226) in LVI positive (1.32, 0.95–2.43) than negative (2.5, 1.92–4.15). There was no significant difference in SFA (p = 0.6009) or PUFA (p = 0.1641). There was no significant correlation between lipid composition against Ki-67 or serotonin, apart from a borderline negative correlation between PUFA and serotonin (r = - 0.3616, p = 0.0496). Conclusion Lipid composition might provide a biomarker to study lymphovascular invasion in breast cancer. Key Points • Monounsaturated fatty acids in lymphovascular invasion (LVI) positive invasive breast carcinoma were significantly lower than that in LVI negative. • Triglycerides in LVI positive invasive breast carcinoma were significantly lower than that in LVI negative. • Lipid composition from MR spectroscopy reflects the rate of de novo lipogenesis and provides a potential biomarker independent from histological grade and stage.

Lactate Dehydrogenase-A (LDH-A) Preserves Cancer Stemness and Recruitment of Tumor-Associated Macrophages to Promote Breast Cancer Progression

“…Except for lactic acid, carbonic anhydrase 9 (CA-9), maintaining the acidic condition of TME, also contributed to the tumor progression ( 38 ). Interestingly, the lipid composition in TME is also an important factor for macrophages recruitment and functional remolding ( 39 ). In our study, by using the co-culturing system in vitro , we find that the recruitment of macrophages is strongly enhanced by LDHA.…”

Overview of Artificial Intelligence in Breast Cancer Medical Imaging

“…Compared with the previous two imaging methods, breast MRI is the most sensitive and accurate imaging method for preoperative staging of breast cancer, and its sensitivity for tumor diagnosis is not affected by the density [ 11 , 67 ]. MRI provides information indicating tumor biological function: spectral imaging can determine the function of chemical components within tissue regions for qualitative tumor diagnosis through metabolite detection [ 68 ]; or MRI spectral imaging can be used for quantitative assessment of lipid composition in the breast based on altered adipogenesis genes in breast cancers with vascular infiltration, allowing prediction of tumor vascular infiltration events [ 69 ], assessment of chemotherapy response [ 70 ], and subtype identification [ 71 ]. Diffusion-weighted imaging (DWI) is highly sensitive for breast cancer as it reveals and evaluates local pathophysiological features by measuring the mobile phase of water molecules in the tissue.…”

Predicting Axillary Response in Hormone Receptor-Positive Breast Cancer after Neoadjuvant Chemotherapy Using Real-World Data

“…Similarly, the study has found that LVI is an independent predictor of survival in breast cancer after neoadjuvant chemotherapy, some scholars also have found that the occurrence of LVI is significantly related to luminal B with HER2(-), and the basal-like subtype [ 20 ]. Cheung SM and Bo Bae Choi et al considered that preoperative magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) can help diagnose the existence of LVI in breast cancer [ 21 , 22 ]. Actually, in our multivariate analysis about HR+ population, patients with LVI had the strongest independent association with residual positive axillary LNs (OR, 6.438; P < 0.05).…”