title: Potential of MR mammography to predict tumor grading of invasive breast cancer.
abstract: OBJECTIVE
  Tumor grading (TG) is one of the most widely used prognostic factors in the case of breast cancer. This study aims to identify the potential of magnetic resonance mammography (MRM) to non-invasively assess TG.
  
  
  METHODS
  399 invasive breast cancers were included (IRB approval; standardized clinical MRM protocols). All breast cancers were prospectively evaluated by two experienced (> 500 MRM) and blinded radiologists in consensus. In every cancer a set of 18 previously published MRM descriptors was assessed. These were assessed by univariate and multivariate analysis to identify the potential of MRM to predict TG (X2 statistics; binary logistic regression; area under the ROC curve [AUC]).
  
  
  RESULTS
  8 of 18 MRM descriptors were associated with TG, e. g. internal structure, edema (p < 0.001), as well as skin thickening and destruction of the nipple line (p < 0.05). MRM was feasible to predict TG by multivariate analysis (p < 0.001). The highest potential could be identified to predict well differentiated breast cancers with good prognosis (AUC = 0.930).
  
  
  CONCLUSIONS
  MR mammography was able to non-invasively assess tumor grading in a standard protocol. Since tumor grading is a surrogate for overall survival, these results provide further evidence to the clinical application of MR mammography as a noninvasive prognostic tool.
authors: Institute of Diagnostic and Interventional Radiology, Friedrich-Schiller-University Jena. wolfram.schmidt@uni-rostock.de
authors: M
authors: M
authors: Dietzel
authors: P A
authors: PA
authors: Baltzer
authors: T
authors: T
authors: Vag
authors: R
authors: R
authors: Zoubi
authors: T
authors: T
authors: Gröschel
authors: H
authors: H
authors: Burmeister
authors: M
authors: M
authors: Gajda
authors: I B
authors: IB
authors: Runnebaum
authors: W A
authors: WA
authors: Kaiser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000145:classification / Q000473:pathology* / Q000601:surgery; D018270:Carcinoma, Ductal, Breast / Q000473:pathology*; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography / Q000379:methods*; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011446:Prospective Studies; D012015:Reference Standards; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA