title: Magnetic resonance imaging features in triple-negative breast cancer: comparison with luminal and HER2-overexpressing tumors.
abstract: BACKGROUND
  It has been ascertained that triple-negative (TN) breast cancer is characterized by an aggressive clinical course and a poor prognosis. The purpose of our study was to compare the magnetic resonance imaging (MRI) features of the 3 major different breast cancer subtypes (TN, luminal, and human epidermal growth factor receptor 2 [HER2]-overexpressing) and to suggest the criteria that might predict TN phenotype.
  
  
  METHODS
  From October 2007 to April 2011, we studied 77 patients with histologically confirmed TN breast cancer who underwent breast MRI. We randomly included 148 patients with non-TN breast cancer (110 luminal and 38 HER-overexpressing) as a control group. We evaluated the clinicopathologic data, the MRI morphologic and kinetic features, the signal intensity on T2-weighted images, and the apparent diffusion coefficient (ADC).
  
  
  RESULTS
  Our results confirmed that TN tumors are more aggressive, are usually diagnosed at a younger age compared with the other study groups, and show benign morphologic features with MRI. Backward stepwise logistic regression identified some parameters as independent predictors of TN-type lesions: age, size, shape, presence of edema, and infiltrative characteristics. The receiver operating characteristic (ROC) curve, built with 4 of 5 these factors as criteria to predict TN status, showed a 0.664 area under the curve (AUC) value (sensitivity 58.4%, specificity 73.2%). The inclusion of the fifth criterion showed a 0.699 AUC value (sensitivity, 49.4%; specificity, 89.4%).
  
  
  CONCLUSIONS
  We identified the clinicoradiologic parameters that are independent predictors of TN breast lesions, which might be helpful for earlier prediction of the TN status of a breast lesion.
authors.affiliation: Department of Radiology, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy.
authors.forename: Melania
authors.initials: M
authors.lastname: Costantini
authors.forename: Paolo
authors.initials: P
authors.lastname: Belli
authors.forename: Daniela
authors.initials: D
authors.lastname: Distefano
authors.forename: Enida
authors.initials: E
authors.lastname: Bufi
authors.forename: Marialuisa Di
authors.initials: MD
authors.lastname: Matteo
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Rinaldi
authors.forename: Michela
authors.initials: M
authors.lastname: Giuliani
authors.forename: Gianluigi
authors.initials: G
authors.lastname: Petrone
authors.forename: Stefano
authors.initials: S
authors.lastname: Magno
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
mesh_terms: D019540:Area Under Curve; D001943:Breast Neoplasms / Q000145:classification / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism*; D011980:Receptors, Progesterone / Q000378:metabolism*; D012189:Retrospective Studies
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone