Korean J Radiol.  2008 Feb;9(1):10-18. 10.3348/kjr.2008.9.1.10.

Correlation between High Resolution Dynamic MR Features and Prognostic Factors in Breast Cancer

• Lee SH
• Cho N
• Kim SJ
• Cha JH
• Cho KS
• Ko ES
• Moon WK

• KMID: 1734270
• DOI: http://doi.org/10.3348/kjr.2008.9.1.10

Abstract

OBJECTIVE
To correlate high resolution dynamic MR features with prognostic factors in breast cancer. MATERIALS AND METHODS: One hundred and ninety-four women with invasive ductal carcinomas underwent dynamic MR imaging using T1-weighted three-dimensional fast low-angle shot (3D-FLASH) sequence within two weeks prior to surgery. Morphological and kinetic MR features were determined based on the breast imaging and reporting data system (BI-RADS) MR imaging lexicon. Histological specimens were analyzed for tumor size, axillary lymph node status, histological grade, expression of estrogen receptor (ER), expression of progesterone receptor (PR), and expression of p53, c-erbB-2, and Ki-67. Correlations between the MR features and prognostic factors were determined using the Pearson chi-square test, linear-by-linear association, and logistic regression analysis. RESULTS: By multivariate analysis, a spiculated margin was a significant, independent predictor of a lower histological grade (p < 0.001), and lower expression of Ki-67 (p = 0.007). Rim enhancement was significant, independent predictor of a higher histological grade (p < 0.001), negative expression of ER (p = 0.001), negative expression of PR (p < 0.001) and a larger tumor size (p = 0.006). A washout curve may predict a higher level of Ki-67 (p = 0.05). Most of the parameters of the initial enhancement phase cannot predict the status of the prognostic factors. Only the enhancement ratio may predict a larger tumor size (p = 0.05). CONCLUSION: Of the BI-RADS-MR features, a spiculated margin may predict favorable prognosis, whereas rim enhancement or washout may predict unfavorable prognosis of breast cancer.

Keyword

Breast neoplasms; Breast, MR; Prognostic factors

MeSH Terms

Adult
Aged
Breast Neoplasms/*pathology
Carcinoma, Ductal/*pathology
Chi-Square Distribution
Contrast Media
Female
Gadolinium DTPA/diagnostic use
Humans
Image Processing, Computer-Assisted
Logistic Models
Magnetic Resonance Imaging/*methods
Middle Aged
Neoplasm Invasiveness
Prognosis
Retrospective Studies

Figure

• 

  Fig. 1 A 56-year-old woman with invasive ductal carcinoma not otherwise specified of histological grade 1, ER (+), PR (+), Ki-67 (-). A. Sagittal standard subtracted fast lowangle shot MR image shows an irregular mass with a spiculated margin (arrow). B. Sagittal reverse subtracted fast lowangle shot MR image shows nonwashout kinetics (arrow). C. Time-signal intensity curve shows plateau late enhancement. D. Photomicrograph shows high proportional tubule formation, low nuclear pleomorphism, and a low mitotic count (Hematoxylin & Eosin staining, ×400).

• 

  Fig. 2 A 48-year-old woman with invasive ductal carcinoma not otherwise specified of histological grade 3, ER (-), PR (-), Ki-67 (+). A. Sagittal standard subtracted fast lowangle shot MR image shows a lobulated mass with rim enhancement (arrow). B. Sagittal reverse subtracted fast lowangle shot MR image shows washout kinetics (arrow). C. Time-signal intensity curve shows washout late enhancement. D. Photomicrograph shows minimal tubule formation, high nuclear pleomorphism, and a high mitotic count (Hematoxylin & Eosin staining, ×400).

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