Janice Sung MD, Presenter: Nothing to Disclose

Maxine S. Jochelson MD, Abstract Co-Author: Investigator, General Electric Company

Sandra Joo MD, Abstract Co-Author: Nothing to Disclose

Chaya Moskowitz, Abstract Co-Author: Nothing to Disclose

Junting Zheng, Abstract Co-Author: Nothing to Disclose

Sandra Brennan MBBCh, MSc, Abstract Co-Author: Nothing to Disclose

D. David Dershaw MD, Abstract Co-Author: Nothing to Disclose

Elizabeth A. Morris MD, Abstract Co-Author: Nothing to Disclose

To evaluate the MRI imaging features of estrogen receptor (ER) negative, progesterone receptor (PR) negative, and human epidermal growth factor receptor 2 (HER2) negative (triple negative, TN) receptor breast cancers compared to the more common ER+/PR+/HER2- breast cancers.

This study was IRB approved. Retrospective review of our database identified 62 patients with pathologically proven TN breast cancer who underwent a preoperative MRI between 2003-2008. Comparison was made to 61 randomly selected patients with ER+/PR+/HER2- breast cancer. Age at diagnosis and tumor size were recorded. Two blinded breast imaging radiologists reviewed MRI imaging features including focality, tumor shape, intratumoral T2 signal intensity, margin, internal enhancement, and enhancement kinetics. Discrepancies were resolved by a third blinded radiologist. The Wilcoxon rank-sum test for continuous variables and the Fisher’s exact test for categorical variables were used to compare features.

Age at cancer diagnosis ranged from 33-69 years (median 50) for the TN group and from 33-74 years (median 49) for the ER+/PR+/HER2- group (p=0.16). Tumor size ranged from 0.2 to 4.8 cm (median 1.6) for the TN cancers and from 0.1 to 6 cm (median 1.3) for the ER+/PR+/HER2- cancers (p=0.10). 84% of the TN cancers demonstrated mass like enhancement, compared to 64% of the ER+/PR+/HER2- cancers (p= 0.01). High T2 intratumoral signal intensity was present in 13% of TN cancers, compared to 2% of the ER+/PR+/HER2- cancers (p= 0.03). 65% of the TN cancers had lobulated margins, compared to 41% of the ER+/PR+/HER2- tumors (p=0.04). 44% of the TN cancers demonstrated rim enhancement, compared to 8% of the ER+/PR+/HER2- tumors (p<0.001). No statistically significant difference was found for focality, enhancement kinetics, or margins.

Imaging findings, including mass like enhancement, high T2 intratumoral signal intensity, rim enhancement, and lobulated margins are associated with TN breast cancers.

Understanding the imaging features associated with TN cancers may aid in image interpretation.

Sung, J, Jochelson, M, Joo, S, Moskowitz, C, Zheng, J, Brennan, S, Dershaw, D, Morris, E, MR Imaging Features of Triple Receptor Negative Breast Cancers.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9004487.html