Can contrast-enhanced MR imaging predict survival in breast cancer?
OBJECTIVE
To investigate the value of pre-operative contrast-enhanced MR imaging (CE-MRI) in predicting the disease-free and overall survival in breast cancer.


METHODS
The study population consisted of 50 consecutive patients with histopathologically verified primary breast cancer who pre-operatively underwent CE-MRI examination between 1992 and 1993. A three-time point MR examination was performed where the enhancement rates (C1 and C2), signal enhancement ratio (SER=C1/C2) and washout (W=C1-C2) were calculated. The relation of these MR parameters to disease-free and overall survival was investigated. The median follow-up for surviving patients was 95 months. Univariate and multivariate statistical analyses were performed to evaluate the impact of different factors on prediction of survival.


RESULTS
Of the MR parameters examined at univariate analysis, increased C1 (p=0.029), W (p=0.0081) and SER values (p=0.0081) were significantly associated with shorter disease-free survival, and only C1 (p=0.016) was related significantly to overall survival. Multivariate analysis for disease-free survival showed that the SER (p=0.014) and tumor size (p=0.001) were significant and independent predictors. Age (p=0.003), lymph node status (p=0.014), tumor size (p=0.039) and proliferating cell nuclear antigen index (p=0.053) remained independently associated with overall survival at multivariate analysis. C1 was not confirmed as an independent predictor of overall survival.


CONCLUSIONS
Our findings support the presumption that CE-MRI is useful in predicting the disease-free survival in patients with breast cancer.
Boné
B
B
Department of Diagnostic Radiology, Huddinge University Hospital, Huddinge, Sweden.
Szabó
B K
BK
Perbeck
L G
LG
Veress
B
B
Aspelin
P
P
D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology*; D003287:Contrast Media; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis; D013997:Time Factors
D003287:Contrast Media