Correlations between dynamic-enhanced magnetic resonance imaging quantitative parameters and postoperative recurrence or metastasis and clinicopathological features in breast cancer patients-a retrospective cohort study

Xuelian Chen; Qian Gao; Zhijuan Wu; Hongyan Wang; Jianliang Wang

doi:10.21037/gs-22-400

Correlations between dynamic-enhanced magnetic resonance imaging quantitative parameters and postoperative recurrence or metastasis and clinicopathological features in breast cancer patients-a retrospective cohort study

Gland Surg. 2022 Aug;11(8):1374-1382. doi: 10.21037/gs-22-400.

Authors

Xuelian Chen¹, Qian Gao¹, Zhijuan Wu¹, Hongyan Wang¹, Jianliang Wang¹

Affiliation

¹ Department of Radiology, Affiliated Kunshan Hospital of Jiangsu University, Kunshan, China.

Abstract

Background: Few related studies focused on the correlations between the quantitative parameters of dynamic-enhanced magnetic resonance imaging (MRI) and the clinical pathological characteristics of patients with invasive breast cancer have been conducted to date. This study sought to explore the value of quantitative parameters of dynamic-enhanced MRI in predicting postoperative recurrence or metastasis in breast cancer patients and their correlations with clinical pathological features, so as to provide clinicians with understanding of MRI in breast cancer.

Methods: From January 2016 to June 2017, 214 invasive breast cancer patients admitted to Affiliated Kunshan Hospital of Jiangsu University were retrospectively enrolled in this study. Dynamic-enhanced MRI was performed to analyze the relationship between quantitative parameters of dynamic-enhanced MRI and recurrence or metastasis, and analyze their correlations with clinical pathological features in patients with invasive breast cancer.

Results: The apparent diffusion coefficient and peak time had certain diagnostic value for postoperative recurrence or metastasis in breast cancer patients, and the areas under the curve were 0.821 [95% confidence interval (CI): 0.732-0.911; P<0.001] and 0.691 (95% CI: 0.609-0.774; P<0.001), respectively. An apparent diffusion coefficient <0.78×10^-3 mm²/s, a peak time <167.50 s, tumor staging (T staging) ≥2, vascular tumor thrombus, and positive lymph nodes were risk factors for postoperative recurrence or metastasis in breast cancer patients (odds ratio: 19.768, 95% CI: 2.577-151.619, P=0.004; 5.708, 95% CI: 1.088-29.947, P=0.039; 122.474, 95% CI: 5.334-2,812.360, P=0.003; 28.304, 95% CI: 1.372-583.914, P=0.030; 314.407, 95% CI: 10.617-9,310.547, P=0.001), and high estrogen receptor (ER) expression was a protective factor for postoperative recurrence or metastasis in breast cancer patients (odds ratio: 0.056, 95% CI: 0.004-0.795, P=0.033). The apparent diffusion coefficient was related to the site of onset, T staging, vascular tumor thrombus, and positive lymph nodes in breast cancer patients (P<0.05). Peak time was related to a high nuclear-associated antigen Ki-67 index, high ER expression, and high progesterone receptor (PR) expression in breast cancer patients (P<0.05).

Conclusions: The quantitative parameters of MRI were associated with clinical pathological characteristics and recurrence or metastasis in breast cancer after surgery.

Keywords: Dynamic-enhanced magnetic resonance imaging (dynamic-enhanced MRI); apparent diffusion coefficient (ADC); invasive breast cancer; peak time.