Advertisement

Morphological MR features and quantitative ADC evaluation in invasive breast cancer: Correlation with prognostic factors

Published:February 17, 2018DOI:https://doi.org/10.1016/j.clinimag.2018.02.011

      Highlights

      • DCE-MRI morphological features can predict invasive breast cancer aggressivity.
      • Quantitative ADC value is related to T and clinical stages.
      • Non-mass enhancement is associated with lobular/mixed histotype.
      • Homogenous enhancement pattern is related to lobular/mixed histotype.
      • Several prognostic factors correlate with invasive breast cancer MRI features.

      Abstract

      Objective

      Assess the correlation between MRI characteristics of invasive breast cancer and tumor prognostic features.

      Materials and methods

      95 women with invasive breast cancer underwent pre-treatment MR. Morphological findings and quantitative ADC were retrospectively evaluated.

      Results

      Smaller size, round shape, spiculated margins and homogeneous internal enhancement pattern on dynamic MRI were independently associated with established predictors of good prognosis, while larger size and rim enhancement pattern were related to predictors of poor prognosis. A positive correlation was observed between ADC value and clinical stage.

      Conclusions

      MRI may be a useful tool for breast cancer aggressiveness prediction and for guiding subsequent clinical-therapeutic management.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Ferlay J.
        • Soerjomataram I.
        • Dikshit R.
        • Eser S.
        • Mathers C.
        • Rebelo M.
        • et al.
        Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012.
        Int J Cancer. 2015; 136: E359-86https://doi.org/10.1002/ijc.29210
        • Elston C.W.
        • Ellis I.O.
        • Pinder S.E.
        Pathological prognostic factors in breast cancer.
        Crit Rev Oncol Hematol. 1999; 31: 209-223
        • Yaghan R.
        • Stanton P.D.
        • Robertson K.W.
        • Going J.J.
        • Murray G.D.
        • McArdle C.S.
        Oestrogen receptor status predicts local recurrence following breast conservation surgery for early breast cancer.
        Eur J Surg Oncol. 1998; 24: 424-426
        • Lovekin C.
        • Ellis I.O.
        • Locker A.
        • Robertson J.F.
        • Bell J.
        • Nicholson J.
        • et al.
        c-erbB-2 oncoprotein expression in primary and advanced breast cancer.
        Br J Cancer. 1991; 63: 439-443
        • Scholzen T.
        • Gerdes J.
        The Ki-67 protein: from the known and the unknown.
        J Cell Physiol. 2000; 182: 311-322https://doi.org/10.1002/(SICI)1097-4652(200003)182:3<311::AID-JCP1>3.0.CO;2-9
        • Onitilo A.A.
        • Engel J.M.
        • Greenlee R.T.
        • Mukesh B.N.
        Breast cancer subtypes based on ER/PR and Her2 expression: comparison of clinicopathologic features and survival.
        Clin Med Res. 2009; 7: 4-13https://doi.org/10.3121/cmr.2009.825
        • Desmedt C.
        • Haibe-Kains B.
        • Wirapati P.
        • Buyse M.
        • Larsimont D.
        • Bontempi G.
        • et al.
        Biological processes associated with breast cancer clinical outcome depend on the molecular subtypes.
        Clin Cancer Res. 2008; 14: 5158-5165https://doi.org/10.1158/1078-0432.CCR-07-4756
        • Lee S.H.
        • Cho N.
        • Kim S.J.
        • Cha J.H.
        • Cho K.S.
        • Ko E.S.
        • et al.
        Correlation between high resolution dynamic MR features and prognostic factors in breast cancer.
        Korean J Radiol. 2008; 9: 10-18https://doi.org/10.3348/kjr.2008.9.1.10
        • Montemurro F.
        • Martincich L.
        • Sarotto I.
        • Bertotto I.
        • Ponzone R.
        • Cellini L.
        • et al.
        Relationship between DCE-MRI morphological and functional features and histopathological characteristics of breast cancer.
        Eur Radiol. 2007; 17: 1490-1497https://doi.org/10.1007/s00330-006-0505-x
        • Szabo B.K.
        • Aspelin P.
        • Kristoffersen Wiberg M.
        • Tot T.
        • Bone B.
        Invasive breast cancer: correlation of dynamic MR features with prognostic factors.
        Eur Radiol. 2003; 13: 2425-2435https://doi.org/10.1007/s00330-003-2000-y
        • Chang Y.W.
        • Kwon K.H.
        • Choi D.L.
        • Lee D.W.
        • Lee M.H.
        • Lee H.K.
        • et al.
        Magnetic resonance imaging of breast cancer and correlation with prognostic factors.
        Acta Radiol. 2009; 50: 990-998https://doi.org/10.3109/02841850903225180
        • Jinguji J.
        • Kajiya Y.
        • Kamimura K.
        • Nakajo M.
        • Sagara Y.
        • Takahama T.
        • et al.
        Rim enhancement of breast cancers on contrast-enhanced MR imaging: relationship with prognostic factors.
        Breast Cancer. 2006; 13: 64-73
        • Teifke A.
        • Behr O.
        • Schmidt M.
        • Victor A.
        • Vomweg T.W.
        • Thelen M.
        • et al.
        Dynamic MR imaging of breast lesions: correlation with microvessel distribution pattern and histologic characteristics of prognosis.
        Radiology. 2006; 239: 351-360https://doi.org/10.1148/radiol.2392050205
        • Tuncbilek N.
        • Karakas H.M.
        • Okten O.O.
        Dynamic magnetic resonance imaging in determining histopathological prognostic factors of invasive breast cancers.
        Eur J Radiol. 2005; 53: 199-205https://doi.org/10.1016/j.ejrad.2003.11.004
        • Fischer U.
        • Kopka L.
        • Brinck U.
        • Korabiowska M.
        • Schauer A.
        • Grabbe E.
        Prognostic value of contrast-enhanced MR mammography in patients with breast cancer.
        Eur Radiol. 1997; 7: 1002-1005
        • Jeh S.K.
        • Kim S.H.
        • Kim H.S.
        • Kang B.J.
        • Jeong S.H.
        • Yim H.W.
        • et al.
        Correlation of the apparent diffusion coefficient value and dynamic magnetic resonance imaging findings with prognostic factors in invasive ductal carcinoma.
        J Magn Reson Imaging. 2011; 33: 102-109https://doi.org/10.1002/jmri.22400
        • Kim S.H.
        • Cha E.S.
        • Kim H.S.
        • Kang B.J.
        • Choi J.J.
        • Jung J.H.
        • et al.
        Diffusion-weighted imaging of breast cancer: correlation of the apparent diffusion coefficient value with prognostic factors.
        J Magn Reson Imaging. 2009; 30: 615-620https://doi.org/10.1002/jmri.21884
        • Martincich L.
        • Deantoni V.
        • Bertotto I.
        • Redana S.
        • Kubatzki F.
        • Sarotto I.
        • et al.
        Correlations between diffusion-weighted imaging and breast cancer biomarkers.
        Eur Radiol. 2012; 22: 1519-1528https://doi.org/10.1007/s00330-012-2403-8
        • Choi S.Y.
        • Chang Y.W.
        • Park H.J.
        • Kim H.J.
        • Hong S.S.
        • Seo D.Y.
        Correlation of the apparent diffusion coefficiency values on diffusion-weighted imaging with prognostic factors for breast cancer.
        Br J Radiol. 2012; 85: e474-9https://doi.org/10.1259/bjr/79381464
        • Costantini M.
        • Belli P.
        • Rinaldi P.
        • Bufi E.
        • Giardina G.
        • Franceschini G.
        • et al.
        Diffusionweighted imaging in breast cancer: relationship between apparent diffusion coefficient and tumour aggressiveness.
        Clin Radiol. 2010; 65: 1005-1012https://doi.org/10.1016/j.crad.2010.07.008
        • Kamitani T.
        • Matsuo Y.
        • Yabuuchi H.
        • Fujita N.
        • Nagao M.
        • Jinnouchi M.
        • et al.
        Correlations between apparent diffusion coefficient values and prognostic factors of breast cancer.
        Magn Reson Med Sci. 2013; 12: 193-199
        • Belli P.
        • Costantini M.
        • Bufi E.
        • Giardina G.G.
        • Rinaldi P.
        • Franceschini G.
        • et al.
        Diffusion magnetic resonance imaging in breast cancer characterisation: correlations between the apparent diffusion coefficient and major prognostic factors.
        Radiol Med. 2015; 120: 268-276https://doi.org/10.1007/s11547-014-0442-8
        • Razek A.A.
        • Gaballa G.
        • Denewer A.
        • Nada N.
        Invasive ductal carcinoma: correlation of apparent diffusion coefficient value with pathological prognostic factors.
        NMR Biomed. 2010; 23: 619-623https://doi.org/10.1002/nbm.1503
        • Youk J.H.
        • Son E.J.
        • Chung J.
        • Kim J.A.
        • Kim E.K.
        Triple-negative invasive breast cancer on dynamic contrast-enhanced and diffusion-weighted MR imaging: comparison with other breast cancer subtypes.
        Eur Radiol. 2012; 22: 1724-1734https://doi.org/10.1007/s00330-012-2425-2
      1. American College of Radiology ACR BI-RADS ATLAS. 5th ed. American College of Radiology, 2013
        • Partridge S.C.
        • McDonald E.S.
        Diffusion weighted MRI of the breast: protocol optimization, guidelines for interpretation, and potential clinical applications.
        Magn Reson Imaging Clin N Am. 2013; 21: 601-624https://doi.org/10.1016/j.mric.2013.04.007
        • Associazione Italiana di Oncologia Medica
        Linee guida Neoplasie della mammella, ed. 2016.
        • Lakhani S.R.
        • Ellis I.O.
        • Schnitt S.J.
        • Tan P.H.
        • van de Vijver M.J.
        WHO classification of tumours of the breast.
        4th ed. IARC, Lyon2012
        • Elston C.W.
        • Ellis I.O.
        Pathological prognostic factors in breast cancer. I. The value of histological grade in breast cancer: experience from a large study with long-term follow-up.
        Histopathology. 1991; 19: 403-410
        • Goldhirsch A.
        • Winer E.P.
        • Coates A.S.
        • Gelber R.D.
        • Piccart-Gebhart M.
        • Thürlimann B.
        • et al.
        Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013.
        Ann Oncol. 2013; 24: 2206-2223https://doi.org/10.1093/annonc/mdt303
        • Cheang M.C.
        • Chia S.K.
        • Voduc D.
        • Gao D.
        • Leung S.
        • Snider J.
        • et al.
        Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer.
        J Natl Cancer Inst. 2009; 101: 736-750https://doi.org/10.1093/jnci/djp082
        • Kennecke H.
        • Yerushalmi R.
        • Woods R.
        • Cheang M.C.
        • Voduc D.
        • Speers C.H.
        • et al.
        Metastatic behavior of breast cancer subtypes.
        Clin Oncol. 2010; 28: 3271-3277https://doi.org/10.1200/JCO.2009.25.9820
        • Edge S.B.
        • Byrd D.R.
        • Compton C.C.
        • Fritz A.G.
        • Greene F.L.
        • Trotti A.
        • et al.
        American Joint Committee on cancer (AJCC) cancer staging manual.
        7th ed. Springer, New York2009
        • Buadu L.D.
        • Murakami J.
        • Murayama S.
        • Hashiguchi N.
        • Sakai S.
        • Masuda K.
        • et al.
        Breast lesions: correlation of contrast medium enhancement patterns on MR images with histopathologic findings and tumor angiogenesis.
        Radiology. 1996; 200: 639-649
        • Chang R.F.
        • Chen H.H.
        • Chang Y.C.
        • Huang C.S.
        • Chen J.H.
        • Lo C.M.
        Quantification of breast tumor heterogeneity for ER status, HER2 status, and TN molecular subtype evaluation on DCE-MRI.
        Magn Reson Imaging. 2016; 34: 809-819https://doi.org/10.1016/j.mri.2016.03.001
        • Cheng L.
        • Bai Y.
        • Zhang J.
        • Liu M.
        • Li X.
        • Zhang A.
        • et al.
        Optimization of apparent diffusion coefficient measured by diffusion-weighted MRI for diagnosis of breast lesions presenting as mass and non-mass-like enhancement.
        Tumour Biol. 2013; 34: 1537-1545https://doi.org/10.1007/s13277-013-0682-6
        • Partridge S.C.
        • Mullins C.D.
        • Kurland B.F.
        • Allain M.D.
        • DeMartini W.B.
        • Eby P.R.
        • et al.
        Apparent diffusion coefficient values for discriminating benign and malignant breast MRI lesions: effects of lesion type and size.
        AJR Am J Roentgenol. 2010; 194: 1664-1673https://doi.org/10.2214/AJR.09.3534
        • Navarro Vilar L.
        • Alandete Germán S.P.
        • Medina García R.
        • Blanc García E.
        • Camarasa Lillo N.
        • Vilar Samper J.
        MR imaging findings in molecular subtypes of breast cancer according to BIRADS system.
        Breast J. 2017; 23: 421-428https://doi.org/10.1111/tbj.12756
        • Angelini G.
        • Marini C.
        • Iacconi C.
        • Mazzotta D.
        • Moretti M.
        • Picano E.
        • et al.
        Magnetic resonance (MR) features in triple negative breast cancer (TNBC) vs receptor positive cancer (nTNBC).
        Clin Imaging. 2017; 49: 12-16https://doi.org/10.1016/j.clinimag.2017.10.016
        • Fernández-Guinea O.
        • Andicoechea A.
        • González L.O.
        • González-Reyes S.
        • Merino A.M.
        • Hernández L.C.
        • et al.
        Relationship between morphological features and kinetic patterns of enhancement of the dynamic breast magnetic resonance imaging and clinicopathological and biological factors in invasive breast cancer.
        BMC Cancer. 2010; 10: 8https://doi.org/10.1186/1471-2407-10-8
        • Stivalet A.
        • Luciani A.
        • Pigneur F.
        • Dao T.H.
        • Beaussart P.
        • Merabet Z.
        • et al.
        Invasive lobular carcinoma of the breast: MRI pathological correlation following bilateral total mastectomy.
        Acta Radiol. 2012; 53: 367-375https://doi.org/10.1258/ar.2012.110477