Ji Youn Kim MD, Abstract Co-Author: Nothing to Disclose

Sung-Hun Kim MD, Abstract Co-Author: Nothing to Disclose

Soung Moon Yang, Presenter: Nothing to Disclose

To correlate the enhancement parameters of dynamic contrast-enhanced magnetic resonance imaging (MRI) with prognostic factors and immunohistochemical subtypes of breast cancer.

A total of 81 breast carcinomas were included in our study. We obtained the following enhancement parameters: 1) background parenchymal enhancement (BPE) and BPE coefficients (BEC) from bilateral breasts, 2) the number of vessels per breast as a representation of whole-breast vascularity. In 50 patients, 3) semiquantitative parameters of tumors (the initial enhancement percentage, the peak enhancement percentage, the time to peak enhancement, the signal enhancement ratio) and 4) perfusion parameters (Ktrans, kep, ve and iAUC) from tumors and ipsilateral breasts. Correlations among parameters and prognostic factors, including tumor size, axillary node status, nuclear grade, histologic grade, estrogen receptor (ER) expression, progesterone receptor (PR) expression, Ki-67, human epidermal growth factor receptor 2 (HER-2) expression, epidermal growth factor receptor (EGFR) expression, bcl-2, CK5/6 and subtypes categorized as luminal, triple negative and HER-2 were analyzed.

BPE was significantly correlated with EGFR expression (p=0.040). BEC was significantly higher in tumors larger than 2 cm than in tumors smaller than 2 cm (p=0.001). The vessel numbers in ipsilateral breasts were higher in tumors larger than 2 cm than in tumors smaller than 2 cm (p=0.034), with higher nuclear grades (grade 3) than with lower nuclear grades (grade 1,2) (p=0.001) and with PR-negative rather than with PR-positive (p=0.010) results. The mean Ktrans was higher in Ki-67-positive tumors than Ki-67 negative tumors (p=0.002). The mean kep was higher in Ki-67-positive tumors than in Ki-67-negative tumors (p=0.005) and in CK5/6-positive tumors than in CK5/6-negative tumors (p=0.015). The mean Ktrans was lower in the ipsilateral breast parenchyma with HER-2-positive tumors compared to HER-2-negative tumors (p=0.012). 

The BPE, BEC and ipsilateral whole-breast vascularity, higher Ktrans and kep of breast cancer and lower Ktrans and iAUC of ipsilateral breast parenchyma may serve as additional predictors of poor prognosis of breast cancer.

Enhancement parameters on breast MRI can predict the prognosis and subtypes of breast cancer and is recommended for the preoperative evaluation of breast cancer patients.

Kim, J, Kim, S, Yang, S, Enhancement Parameters on Dynamic Contrast-enhanced Breast MRI: Do They Correlate with Prognostic Factors and Subtypes of Breast Cancers?.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14010333.html