Hounsfield Units Predict Survival of Patients With Estrogen Receptor-Positive and Human Epithelial Growth Factor Receptor 2-Negative Breast Cancer

Seung Taek Lim; Hyang Suk Choi; Kwangmin Kim; Seok Hahn; In-Jeong Cho; Hany Noh; Jong-In Lee; Airi Han

doi:10.1016/j.clbc.2023.06.012

Hounsfield Units Predict Survival of Patients With Estrogen Receptor-Positive and Human Epithelial Growth Factor Receptor 2-Negative Breast Cancer

Clin Breast Cancer. 2023 Oct;23(7):e424-e433.e3. doi: 10.1016/j.clbc.2023.06.012. Epub 2023 Jul 5.

Authors

Seung Taek Lim¹, Hyang Suk Choi², Kwangmin Kim², Seok Hahn³, In-Jeong Cho², Hany Noh², Jong-In Lee¹, Airi Han⁴

Affiliations

¹ Department of Oncology, Yonsei University Wonju College of Medicine, Wonju, Korea.
² Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea.
³ Department of Radiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan, Korea.
⁴ Department of Surgery, Yonsei University Wonju College of Medicine, Wonju, Korea. Electronic address: airihan@yonsei.ac.kr.

PMID: 37438195
DOI: 10.1016/j.clbc.2023.06.012

Abstract

Backgrounds: Tumor vascularity plays a fundamental role in cancer progression, including breast cancer. This study aimed to elucidate tumor vascularity and its impact on patient survival in the context of breast cancer subtypes using Hounsfield units (HU) on contrast-enhanced computed tomography (CT).

Materials and methods: Patients with early-stage breast cancer who completed planned treatment between 2003 and 2013 were retrospectively assessed.

Results: The final cohort comprised 440 patients. Of the 440 patients, 262 had estrogen receptor (ER)-positive disease and 119 had human epidermal growth factor receptor 2 (HER2)-overexpressing disease. The tumor-to-aorta ratio of Hounsfield units (TAR) was related to significantly worse recurrence-free interval (RFI) (P < .001) and overall survival (OS) (P < .001) in patients with TAR > 0.33 for RFI and > 0.35 for OS than their counterparts. In the subgroup analysis, the survival disadvantage was limited only to patients with ER-positive and HER2-negative disease (P < .001 for both RFI and OS).

Conclusion: This study showed that TAR, which reflects tumor vascularity, was significantly related to patients' RFI and OS, suggesting its capacity as a feasible biomarker. This study also showed that TAR was associated with the survival in patients with ER-positive and HER2-negative disease.

Keywords: Breast neoplasms; Subtype; Vascularity.