Sachiko Yuen1,2, Shuichi Monzawa3, Seiji Yanai4,5, Hajime Matsumoto4,5, Yoshihiro Yata4,5, You Ichinose5, Teruyuki Deai5, Takashi Hashimoto5, Takashi Tashiro6, Kazuhiko Yamagami4,5. 1. Breast Research Center, The Shinko Institution for Medical Research, Shinko Hospital, 1-4-47, Wakinohama Chuo, Kobe, 651-0072, Japan. syuen@koto.kpu-m.ac.jp. 2. Department of Breast Surgery and Oncology, Shinko Hospital, Kobe, Japan. syuen@koto.kpu-m.ac.jp. 3. Department of Diagnostic Radiology, Shinko Hospital, Kobe, Japan. 4. Breast Research Center, The Shinko Institution for Medical Research, Shinko Hospital, 1-4-47, Wakinohama Chuo, Kobe, 651-0072, Japan. 5. Department of Breast Surgery and Oncology, Shinko Hospital, Kobe, Japan. 6. Department of Pathology, Shinko Hospital, Kobe, Japan.
Abstract
PURPOSE: To assess morphology on diffusion-weighted imaging (DWI) and intratumoral signal intensity (SI) on T2-weighted images (T2WI) of breast carcinomas, and to evaluate the association between the combined DWI and T2WI findings and breast cancer subtypes. METHODS: Two hundred and eighty breast cancer patients who underwent breast MRI prior to therapy were included in this retrospective study. All had invasive carcinomas, which were classified into five subtypes: Luminal A-like (n = 149), Luminal B-like (n = 63), Hormone receptor-positive HER2 (n = 31), Hormone receptor-negative HER2 (n = 13), or Triple-negative (TN) (n = 24). Based on the morphology on DWI, the tumors were classified into two patterns: DWI-homogeneous or DWI-heterogeneous. If DWI-heterogeneous, an assessment of intratumoral SI on T2WI was performed: tumors with intratumoral high/low SI on T2WI were classified as Hete-H/Hete-L, respectively. The associations between (1) the morphological patterns on DWI and the five subtypes, and (2) the intratumoral SI patterns on T2WI and the five subtypes in DWI-heterogeneous were evaluated. RESULTS: There was a significant association between (1) the morphological patterns on DWI and the five subtypes (p < 0.0001), and (2) the intratumoral SI patterns on T2WI and the five subtypes in DWI-heterogeneous (p < 0.0001). DWI-homogeneous was dominant in Luminal A-like (67.1%), and Hete-H was dominant in TN type (75%). Hete-H, suggesting the presence of intratumoral necrosis, included high proliferative and/or aggressive subtypes more frequently (80%) than Hete-L, suggesting the presence of fibrotic focus. Fibrotic focus was seen more commonly in the luminal subtypes. CONCLUSION: The combined findings on DWI and T2WI revealed breast carcinomas that were associated with particular subtypes.
PURPOSE: To assess morphology on diffusion-weighted imaging (DWI) and intratumoral signal intensity (SI) on T2-weighted images (T2WI) of breast carcinomas, and to evaluate the association between the combined DWI and T2WI findings and breast cancer subtypes. METHODS: Two hundred and eighty breast cancerpatients who underwent breast MRI prior to therapy were included in this retrospective study. All had invasive carcinomas, which were classified into five subtypes: Luminal A-like (n = 149), Luminal B-like (n = 63), Hormone receptor-positive HER2 (n = 31), Hormone receptor-negative HER2 (n = 13), or Triple-negative (TN) (n = 24). Based on the morphology on DWI, the tumors were classified into two patterns: DWI-homogeneous or DWI-heterogeneous. If DWI-heterogeneous, an assessment of intratumoral SI on T2WI was performed: tumors with intratumoral high/low SI on T2WI were classified as Hete-H/Hete-L, respectively. The associations between (1) the morphological patterns on DWI and the five subtypes, and (2) the intratumoral SI patterns on T2WI and the five subtypes in DWI-heterogeneous were evaluated. RESULTS: There was a significant association between (1) the morphological patterns on DWI and the five subtypes (p < 0.0001), and (2) the intratumoral SI patterns on T2WI and the five subtypes in DWI-heterogeneous (p < 0.0001). DWI-homogeneous was dominant in Luminal A-like (67.1%), and Hete-H was dominant in TN type (75%). Hete-H, suggesting the presence of intratumoral necrosis, included high proliferative and/or aggressive subtypes more frequently (80%) than Hete-L, suggesting the presence of fibrotic focus. Fibrotic focus was seen more commonly in the luminal subtypes. CONCLUSION: The combined findings on DWI and T2WI revealed breast carcinomas that were associated with particular subtypes.
Entities:
Keywords:
Breast cancer; Diffusion-weighted imaging; Magnetic resonance imaging; Molecular subtype; T2-weighted imaging