Gi Won Shin1,2, Yang Zhang3, Min Jung Kim1, Min-Ying Su3, Eun-Kyung Kim1, Hee Jung Moon1, Jung Hyun Yoon1, Vivian Youngjean Park1. 1. Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. 2. Department of Radiology, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea. 3. Department of Radiological Sciences, Tu & Yuen Center for Functional Onco-Imaging. University of California, Irvine, California, USA.
Abstract
BACKGROUND: Background parenchymal enhancement (BPE) on dynamic contrast-enhanced (DCE)-MRI has been associated with breast cancer risk, both based on qualitative and quantitative assessments. PURPOSE: To investigate whether BPE of the contralateral breast on preoperative DCE-MRI is associated with therapy outcome in ER-positive, HER2-negative, node-negative invasive breast cancer. STUDY TYPE: Retrospective. POPULATION: In all, 289 patients with unilateral ER-positive, HER2-negative, node-negative breast cancer larger than 5 mm. FIELD STRENGTH/SEQUENCE: 3T, T1 -weighted DCE sequence. ASSESSMENT: BPE of the contralateral breast was assessed qualitatively by two dedicated radiologists and quantitatively (using region-of-interest and automatic breast segmentation). STATISTICAL TESTS: Cox regression analysis was used to determine associations with recurrence-free survival (RFS) and distant metastasis-free survival (DFS). Interobserver variability for parenchymal enhancement was assessed using kappa statistics and intraclass correlation coefficient (ICC). RESULTS: The median follow-up time was 75.8 months. Multivariate analysis showed receipt of total mastectomy (hazard ratio [HR]: 5.497) and high Ki-67 expression level (HR: 5.956) were independent factors associated with worse RFS (P < 0.05). Only a high Ki-67 expression level was associated with worse DFS (HR: 3.571, P = 0.045). BPE assessments were not associated with outcome (RFS [qualitative BPE: P = 0.75, 0.92 for readers 1 and 2; quantitative BPE: P = 0.38-0.99], DFS, [qualitative BPE: P = 0.41, 0.16 for readers 1 and 2; quantitative BPE: P = 0.68-0.99]). For interobserver variability, there was good agreement between qualitative (κ = 0.700) and good to perfect agreement for most quantitative parameters of BPE. DATA CONCLUSION: Contralateral BPE showed no association with survival outcome in patients with ER-positive, HER2-negative, node-negative invasive breast cancer. A high Ki-67 expression level was associated with both worse recurrence-free and distant metastasis-free survival. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2018;48:1678-1689.
BACKGROUND: Background parenchymal enhancement (BPE) on dynamic contrast-enhanced (DCE)-MRI has been associated with breast cancer risk, both based on qualitative and quantitative assessments. PURPOSE: To investigate whether BPE of the contralateral breast on preoperative DCE-MRI is associated with therapy outcome in ER-positive, HER2-negative, node-negative invasive breast cancer. STUDY TYPE: Retrospective. POPULATION: In all, 289 patients with unilateral ER-positive, HER2-negative, node-negative breast cancer larger than 5 mm. FIELD STRENGTH/SEQUENCE: 3T, T1 -weighted DCE sequence. ASSESSMENT: BPE of the contralateral breast was assessed qualitatively by two dedicated radiologists and quantitatively (using region-of-interest and automatic breast segmentation). STATISTICAL TESTS: Cox regression analysis was used to determine associations with recurrence-free survival (RFS) and distant metastasis-free survival (DFS). Interobserver variability for parenchymal enhancement was assessed using kappa statistics and intraclass correlation coefficient (ICC). RESULTS: The median follow-up time was 75.8 months. Multivariate analysis showed receipt of total mastectomy (hazard ratio [HR]: 5.497) and high Ki-67 expression level (HR: 5.956) were independent factors associated with worse RFS (P < 0.05). Only a high Ki-67 expression level was associated with worse DFS (HR: 3.571, P = 0.045). BPE assessments were not associated with outcome (RFS [qualitative BPE: P = 0.75, 0.92 for readers 1 and 2; quantitative BPE: P = 0.38-0.99], DFS, [qualitative BPE: P = 0.41, 0.16 for readers 1 and 2; quantitative BPE: P = 0.68-0.99]). For interobserver variability, there was good agreement between qualitative (κ = 0.700) and good to perfect agreement for most quantitative parameters of BPE. DATA CONCLUSION: Contralateral BPE showed no association with survival outcome in patients with ER-positive, HER2-negative, node-negative invasive breast cancer. A high Ki-67 expression level was associated with both worse recurrence-free and distant metastasis-free survival. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2018;48:1678-1689.
Authors: Geraldine J Liao; Leah C Henze Bancroft; Roberta M Strigel; Rhea D Chitalia; Despina Kontos; Linda Moy; Savannah C Partridge; Habib Rahbar Journal: J Magn Reson Imaging Date: 2019-04-19 Impact factor: 4.813
Authors: Roberto Lo Gullo; Isaac Daimiel; Carolina Rossi Saccarelli; Almir Bitencourt; Varadan Sevilimedu; Danny F Martinez; Maxine S Jochelson; Elizabeth A Morris; Jeffrey S Reiner; Katja Pinker Journal: Breast Cancer Res Date: 2020-08-20 Impact factor: 6.466