Correlation between high resolution dynamic MR features and prognostic factors in breast cancer.
OBJECTIVE
To correlate high resolution dynamic MR features with prognostic factors in breast cancer.


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(2) 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).


CONCLUSIONS
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.
Lee
Shin Ho
SH
Department of Radiology, Seoul National University College of Medicine and Institute of Radiation Medicine, Seoul National University Medical Research Center, Chongno-Gu, Seoul, Korea.
Cho
Nariya
N
Kim
Seung Ja
SJ
Cha
Joo Hee
JH
Cho
Kyung Soo
KS
Ko
Eun Sook
ES
Moon
Woo Kyung
WK
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology*; D044584:Carcinoma, Ductal / Q000473:pathology*; D016009:Chi-Square Distribution; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies
D003287:Contrast Media; D019786:Gadolinium DTPA