Valentine Mberu1, Jennifer McFarlane2, E Jane Macaskill3, Andrew Evans1. 1. University of Dundee, School of Medicine, Ninewells Hospital, Dundee, UK. 2. Medical Physics, Ninewells Hospital, Dundee, UK. 3. Breast Surgery, Ninewells Hospital, Dundee, UK.
Abstract
OBJECTIVES: To identify associations between MRI-detected skin thickening and enhancement and metastasis-free survival (MFS) given recent reports of skin thickening on ultrasound being a poorer prognostic indicator. METHODS: Interrogation of a prospectively collected database of ultrasound-visible breast lesions showed 214 lesions with pre-treatment MRIs available for analysis in a single centre. Data on MFS was prospectively collected. Retrospective MRI review was performed blinded to outcome. Imaging factors recorded were presence of skin thickening and enhancement, non-mass-enhancement (NME) and abnormal nodes, mass characteristics, perilesional oedema and background parenchymal enhancement. Statistical analysis used chi-squared test, Kaplan-Meier survival curves, the Log-rank test and receiver-operator characteristic (ROC) curves. RESULTS: During a median follow-up period of 5.6 years, 21 (10%) of 212 patients developed distant metastases. Skin thickening [24 of 30 (80%) vs 169 of 184 (92%), p = 0.043] and skin enhancement [15 of 20 (75%) vs 178 of 194 (92%), p = 0.016] were associated with poorer MFS. Large index lesion size [p < 0.001, AUC 0.823], large sum of masses [p < 0.001, AUC 0.813], increasing total lesion extent including NME [p < 0.001, AUC 0.749] and abnormal axillary nodes [55 of 66 (83%) vs 138 of 148 (93%), p = 0.024] were also associated with poorer MFS. CONCLUSIONS: Skin thickening and enhancement on breast MRI are associated with poorer MFS. These findings should be taken into account when managing patients with invasive breast cancer. ADVANCES IN KNOWLEDGE: Skin enhancement on breast MRI at diagnosis is associated with metastases development. Skin thickening on breast MRI is associated with future metastatic disease.
OBJECTIVES: To identify associations between MRI-detected skin thickening and enhancement and metastasis-free survival (MFS) given recent reports of skin thickening on ultrasound being a poorer prognostic indicator. METHODS: Interrogation of a prospectively collected database of ultrasound-visible breast lesions showed 214 lesions with pre-treatment MRIs available for analysis in a single centre. Data on MFS was prospectively collected. Retrospective MRI review was performed blinded to outcome. Imaging factors recorded were presence of skin thickening and enhancement, non-mass-enhancement (NME) and abnormal nodes, mass characteristics, perilesional oedema and background parenchymal enhancement. Statistical analysis used chi-squared test, Kaplan-Meier survival curves, the Log-rank test and receiver-operator characteristic (ROC) curves. RESULTS: During a median follow-up period of 5.6 years, 21 (10%) of 212 patients developed distant metastases. Skin thickening [24 of 30 (80%) vs 169 of 184 (92%), p = 0.043] and skin enhancement [15 of 20 (75%) vs 178 of 194 (92%), p = 0.016] were associated with poorer MFS. Large index lesion size [p < 0.001, AUC 0.823], large sum of masses [p < 0.001, AUC 0.813], increasing total lesion extent including NME [p < 0.001, AUC 0.749] and abnormal axillary nodes [55 of 66 (83%) vs 138 of 148 (93%), p = 0.024] were also associated with poorer MFS. CONCLUSIONS: Skin thickening and enhancement on breast MRI are associated with poorer MFS. These findings should be taken into account when managing patients with invasive breast cancer. ADVANCES IN KNOWLEDGE: Skin enhancement on breast MRI at diagnosis is associated with metastases development. Skin thickening on breast MRI is associated with future metastatic disease.
Authors: J Brown; D Buckley; A Coulthard; A K Dixon; J M Dixon; D F Easton; R A Eeles; D G Evans; F G Gilbert; M Graves; C Hayes; J P Jenkins; A P Jones; S F Keevil; M O Leach; G P Liney; S M Moss; A R Padhani; G J Parker; L J Pointon; B A Ponder; T W Redpath; J P Sloane; L W Turnbull; L G Walker; R M Warren Journal: Magn Reson Imaging Date: 2000-09 Impact factor: 2.546
Authors: Ana Belén Cuesta Cuesta; María Dolores Martín Ríos; María Rosario Noguero Meseguer; Juan Antonio García Velasco; María de Matías Martínez; Sara Bartolomé Sotillos; Eduardo Abreu Griego Journal: Cir Esp (Engl Ed) Date: 2019-06-09
Authors: Pascal A T Baltzer; Ramy Zoubi; Hartmut P Burmeister; Mieczyslaw Gajda; Oumar Camara; Werner A Kaiser; Matthias Dietzel Journal: Technol Cancer Res Treat Date: 2012-05-07