Magnetic resonance imaging of breast cancer and correlation with prognostic factors.
BACKGROUND
Prognostic factors of breast cancer have been used for the prediction of clinical outcome or selection of patients for complementary treatment. Some of the imaging features of breast cancer, e.g. magnetic resonance imaging (MRI), are associated with these prognostic factors.


OBJECTIVE
To evaluate the relationship between dynamic enhanced MR features and prognostic factors of clinical outcome of breast cancer.


METHODS
A total of 136 patients with 151 breast cancers underwent 1.5T dynamic MR imaging with the use of a dynamic T1-weighted three-dimensional fast low-angle shot (FLASH) subtraction imaging technique. Morphological and kinetic analyses of MR features were evaluated using the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS) MRI lexicon. Pathological prognostic factors were correlated with MR imaging characteristics, including tumor size, histological grade, lymph node status, expression of estrogen receptor (ER), expression of progesterone receptor (PR), expression of c-erbB2, determination of Ki-67 index, and microvascular density (MVD), using univariate and multivariate statistical analyses.


RESULTS
Based on univariate and multivariate analyses, spiculated tumor margins correlated significantly with lower histological grade (I-II) and positive PR expression. Rim enhancement was significantly correlated with high histological grade, presence of axillary lymph node metastasis, large tumor size, increased Ki-67 index, and increased MVD. Early peak enhancement, as seen on the first scan after contrast medium injection, was correlated with negative ER expression.


CONCLUSIONS
The presence of a lesion with a spiculated margin may predict a relatively good prognosis, and the presence of a lesion with rim enhancement may predict a relatively poor prognosis.
Departments of Radiology, College of Medicine, Soonchunhyang University Hospital, Seoul, Korea. ywchang@hosp.sch.ac.kr
Yun-Woo
YW
Chang
Kui Hyang
KH
Kwon
Deuk Lin
DL
Choi
Dong Wha
DW
Lee
Min Hyuk
MH
Lee
Hye Kyung
HK
Lee
Seung Boo
SB
Yang
Yongbae
Y
Kim
Dae Young
DY
Seo
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D001943:Breast Neoplasms / Q000473:pathology*; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D008197:Lymph Node Excision; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone; D012189:Retrospective Studies
D015415:Biomarkers; D003287:Contrast Media; D019786:Gadolinium DTPA; D019394:Ki-67 Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C064925:gadodiamide