Sade Udoetuk BS, Presenter: Nothing to Disclose

Emily F. Conant MD, Abstract Co-Author: Research grant, General Electric Company

Mark Alan Rosen MD, PhD, Abstract Co-Author: Nothing to Disclose

Julia Tchou MD, Abstract Co-Author: Nothing to Disclose

Mitchell Dennis Schnall MD, PhD, Abstract Co-Author: Research funded, Siemens Consultant, General Electric Company

To compare the imaging features and clinical presentations of triple negative cancers with those of other breast cancers.

284 women with breast cancer were enrolled in an IRB-approved imaging trial from 3/02-3/06. Patients underwent bilateral film screen mammography (FS), bilateral digital mammography (DM), bilateral whole breast ultrasound (US), bilateral contrast enhanced magnetic resonance imaging (CEMR), and whole body positron emission tomography (PET). Triple negative (TN) tumors were identified by immunohistology. Imaging reports and patient charts were reviewed for imaging characteristics, clinical presentation, biopsy results and staging.

We found 31/284 (11%) of women were classified as having TN cancers. Of the participants, 12/50 (24%) black women had TN cancers compared to 19/234 (8%) non-black women (p = 0.002). Of patients with clinical charts available for review, 19/31 (61%) TN and 104/232 (45%) non TN women presented with self-palpated breast lumps or other clinical symptoms (p = 0.21). 12/31 (39%) TN and 51/232 (22%) non TN women reported having a negative mammogram within 18 months of diagnosis (p = 0.074). 30 of the 31 TN cases were invasive tumors, one case was multifocal DCIS. This is in contrast to 61/253 (24%) of non TN cases which were DCIS. 13/31 (42%) TN women had positive lymph nodes versus 43/253 (17%) non TN women (p = 0.004). Of patients with histologic grading, high grade tumors were found in 25/28 (89%) of the TN and 56/122 (46%) of non TN cases (p < 0.001). Excluding women who underwent imaging after excisional biopsy, tumors were described as round or oval masses by either MR or US in 5/27 (18.5%) TN and 6/140 (4%) non-TN lesions (p = 0.008). On CEMR, enhancement intensity and heterogeneity was significantly greater in TN lesions than in non TN lesions.

Triple negative cancers more often present as high grade interval cancers that appear frequently as round or oval masses on multimodality imaging.

Awareness of the interval appearance of triple negative cancers may promote earlier detection and characterization.

Udoetuk, S, Conant, E, Rosen, M, Tchou, J, Schnall, M, Multimodality Imaging and Clinical Presentation of Triple Negative Breast Cancers.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005007.html