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03.01.2020 | Breast

Cone-beam breast CT features associated with HER2/neu overexpression in patients with primary breast cancer

verfasst von: Yueqiang Zhu, Yuwei Zhang, Yue Ma, Haijie Li, Aidi Liu, Peng Han, Lu Yin, Nan Lv, Zhijun Li, Hong Lu, Peifang Liu, Zhaoxiang Ye

Erschienen in: European Radiology | Ausgabe 5/2020

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Abstract

Objectives

To identify the relationship between human epidermal growth factor receptor 2 (HER2) status and cone-beam breast CT (CBBCT) characteristics in surgically resected breast cancer.

Methods

Preoperative CBBCT of patients with BI-RADS 4 or 5 lesions identified on mammography or ultrasound and dense or very dense breast tissue were retrospectively evaluated in 181 surgically resected breast cancer (triple-negative excluded) between May 2012 and November 2014. A set of CBBCT descriptors was semiquantitatively assessed by consensus double reading. Reader reproducibility was analyzed. Multivariable logistic regression analysis using backward elimination (BEA) with the Wald criterion was performed to identify independent predictive factors of harboring HER2/neu. Principle component analysis (PCA) was used to determine characteristics that might differentiate HER2 status. Receiver operating characteristic (ROC) curve analyses were conducted to determine the predictive capability.

Results

HER2 positive was found in 101 (55.8%) of 181 patients. Inter-observer agreement was high for characteristics’ assessment. Based on BEA, pathologic grade, maximum dimension, lobulation, ΔCT, and calcification morphology were confirmed as independent predictive factors of HER2/neu overexpression. PCA showed that calcification- and border-related characteristics were the most important for differentiation. ROC curve analyses showed that CBBCT features (AUC = 0.853) were superior to clinicopathologic features (AUC = 0.613, p < 0.001) and comparable with combination (AUC = 0.856, p = 0.866).

Conclusions

CBBCT features could be used to prognosticate HER2 status independently, which are potentially complementary to histopathologic result and helpful in guiding biopsy.

Key Points

• Dmax, lobulation, ΔCT, and calcification morphology are independent predictors of HER2 status.

• CBBCT features are superior to clinicopathologic features in HER2+/− discrimination.

• CBBCT features are comparable with combination with clinicopathologic features in HER2+/− discrimination.

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Titel: Cone-beam breast CT features associated with HER2/neu overexpression in patients with primary breast cancer
verfasst von: Yueqiang Zhu
Yuwei Zhang
Yue Ma
Haijie Li
Aidi Liu
Peng Han
Lu Yin
Nan Lv
Zhijun Li
Hong Lu
Peifang Liu
Zhaoxiang Ye
Publikationsdatum: 03.01.2020
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 5/2020
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-019-06587-w

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Cone-beam breast CT features associated with HER2/neu overexpression in patients with primary breast cancer