Elizabeth J. Sutton MD, Presenter: Nothing to Disclose

Kirti Magudia PhD, Abstract Co-Author: Nothing to Disclose

Anne S Reiner MPH, Abstract Co-Author: Nothing to Disclose

Monica Morrow MD, 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

Oncotype Dx® breast cancer 21-gene assay recurrence score (RS) is used clinically in early stage estrogen receptor (ER) positive breast cancer to quantify (range 0-100) the likelihood (increased with score) of recurrence and magnitude of chemotherapy benefit. The purpose of this study was to assess ER positive, HER2 negative early breast cancer pre-operative magnetic resonance imaging (MRI) features and their ability to predict the Oncotype Dx® RS.

This retrospective study received institutional review board approval and need for informed consent waived. Pre-operative MRIs were reviewed of 50 women (mean age 51; range 32-76) with ER positive, HER2 negative early invasive ductal carcinoma (IDC) and an Oncotype Dx® (Genomic Health) RS (mean score 23; range 0-78). MRI features included mass shape, margin, internal enhancement, T2 signal, diameter (mean 1.4 cm, range 0.5-2.8 cm), volume (mean 1.4 cc, range 0.1-8.0 cc) and dynamic time-intensity contrast enhancement kinetics. Clinical and pathologic data was collected. Exclusion criteria included prior history of cancer and BRCA genetic carriers.

All 50 women had stage 1 or 2A ER positive, HER 2 negative IDC. Increased Oncotype Dx® recurrence score was significantly associated with increased tumor volume (Spearman correlation=0.35; p=0.01) and an increased percent of the tumor having plateau dynamic kinetics upon segmentation (Spearman correlation=0.32; p=0.03). Increased Oncotype Dx® recurrence score was significantly associated with irregular tumor shape (p=0.03) and increased tumor (hyperintense and heterogeneous) T2 signal (p=0.002).

Several IDC MRI features are significantly associated with an increased Oncotype Dx® RS, which has prognostic and predictive significance.

MRI IDC phenotype is significantly associated with their genotype supporting the advent of radiogenomics and possible role in directing targeted therapy.

Sutton, E, Magudia, K, Reiner, A, Morrow, M, Dershaw, D, Morris, E, Breast Cancer 21-gene Assay Recurrence Score: Correlation between MR Imaging Phenotype and Genotype.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13023050.html