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Erschienen in: Breast Cancer 6/2014

01.11.2014 | Original Article

Is evaluation of the presence of prepectoral edema on T2-weighted with fat-suppression 3 T breast MRI a simple and readily available noninvasive technique for estimation of prognosis in patients with breast cancer?

verfasst von: Takayoshi Uematsu, Masako Kasami, Junichiro Watanabe

Erschienen in: Breast Cancer | Ausgabe 6/2014

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Abstract

Background

The specificity of breast MRI is only moderate. The unsatisfactory specificity of breast MRI has prompted evaluation of high signal intensity (SI) on T2-weighted imaging (T2WI). The purpose of the study was to investigate the prevalence of prepectoral edema determined using high SI on T2WI with fat-suppression 3 T MRI and to correlate its presence with prognostic factors of breast cancer.

Methods

The retrospective study comprised 589 consecutive histopathologically confirmed lesions, 460 malignant and 129 benign, identified by 3 T MRI. Presence of prepectoral edema was evaluated on T2WI with fat suppression, and its diagnostic value for malignancies and correlation with clinicopathological findings in histopathologically confirmed breast cancer were assessed.

Results

Prepectoral edema was present in 54 of the 460 breast cancers (9 % of the total 589) and none of the 129 benign lesions. Its sensitivity and specificity were 12 and 100 %, respectively. The positive predictive value was 100 %. Young age (p = 0.01), large tumor size (p < 0.0001), high histological grade (p < 0.0001), invasive ductal carcinoma (p < 0.0001), high lymphovascular invasion degree (p < 0.0001), high axillary lymph node positivity (p < 0.0001), high inflammatory breast cancer rate (p < 0.0001), high neoadjuvant chemotherapy rate (p < 0.0001), and chemoresistant breast cancers (p < 0.0001) were significantly associated with prepectoral edema. There was no association of the morphological lesion type on MRI and dynamic enhancement imaging pattern with the presence of prepectoral edema.

Conclusion

Prepectoral edema has low prevalence but is specific for breast cancer and correlated with prognostic factors.
Literatur
1.
Zurück zum Zitat Elsamaloty H, Elzawawi MS, Mohammad S, Herial N. Increasing accuracy of detection of breast cancer with 3-T MRI. Am J Roentgenol. 2009;192:1142–8.CrossRef Elsamaloty H, Elzawawi MS, Mohammad S, Herial N. Increasing accuracy of detection of breast cancer with 3-T MRI. Am J Roentgenol. 2009;192:1142–8.CrossRef
2.
Zurück zum Zitat Schmitz AC, Peters NH, Veldhuis WB, et al. Contrast-enhanced 3.0-T breast MRI for characterization of breast lesions: increased specificity by using vascular maps. Eur Radiol. 2008;18:355–64.PubMedCrossRef Schmitz AC, Peters NH, Veldhuis WB, et al. Contrast-enhanced 3.0-T breast MRI for characterization of breast lesions: increased specificity by using vascular maps. Eur Radiol. 2008;18:355–64.PubMedCrossRef
3.
Zurück zum Zitat Pinker K, Grabner G, Bogner W, et al. A combined high temporal and high spatial resolution 3 Tesla MR imaging protocol for the assessment of breast lesions: initial results. Invest Radiol. 2009;44:553–8.PubMedCrossRef Pinker K, Grabner G, Bogner W, et al. A combined high temporal and high spatial resolution 3 Tesla MR imaging protocol for the assessment of breast lesions: initial results. Invest Radiol. 2009;44:553–8.PubMedCrossRef
4.
Zurück zum Zitat Pinker-Domenig K, Bogner W, Gruber S, et al. High resolution MRI of the breast at 3 T: which BI-RADS® descriptors are most strongly associated with the diagnosis of breast cancer? Eur Radiol. 2012;22:322–30.PubMedCrossRef Pinker-Domenig K, Bogner W, Gruber S, et al. High resolution MRI of the breast at 3 T: which BI-RADS® descriptors are most strongly associated with the diagnosis of breast cancer? Eur Radiol. 2012;22:322–30.PubMedCrossRef
5.
Zurück zum Zitat Uematsu T, Kasami M, Yuen S, Igarashi T, Nasu H. Comparison of 3- and 1.5-T Dynamic Breast MRI for Visualization of Spiculated Masses Previously Identified Using Mammography. Am J Roentgenol. 2012;198:W611–7.CrossRef Uematsu T, Kasami M, Yuen S, Igarashi T, Nasu H. Comparison of 3- and 1.5-T Dynamic Breast MRI for Visualization of Spiculated Masses Previously Identified Using Mammography. Am J Roentgenol. 2012;198:W611–7.CrossRef
6.
Zurück zum Zitat Uematsu T, Kasami M. High-spatial-resolution 3-T breast MRI of nonmasslike enhancement lesions: an analysis of their features as significant predictors of malignancy. Am J Roentgenol. 2012;198:1223–30.CrossRef Uematsu T, Kasami M. High-spatial-resolution 3-T breast MRI of nonmasslike enhancement lesions: an analysis of their features as significant predictors of malignancy. Am J Roentgenol. 2012;198:1223–30.CrossRef
7.
Zurück zum Zitat Baltzer PA, Dietzel M, Kaiser WA. Nonmass lesions in magnetic resonance imaging of the breast: additional T2-weighted images improve diagnostic accuracy. J Comput Assist Tomogr. 2011;35:361–6.PubMedCrossRef Baltzer PA, Dietzel M, Kaiser WA. Nonmass lesions in magnetic resonance imaging of the breast: additional T2-weighted images improve diagnostic accuracy. J Comput Assist Tomogr. 2011;35:361–6.PubMedCrossRef
8.
Zurück zum Zitat Baltzer PA, Yang F, Dietzel M, et al. Sensitivity and specificity of unilateral edema on T2w-TSE sequences in MR-mammography considering 974 histologically verified lesions. Breast J. 2010;16:233–9.PubMedCrossRef Baltzer PA, Yang F, Dietzel M, et al. Sensitivity and specificity of unilateral edema on T2w-TSE sequences in MR-mammography considering 974 histologically verified lesions. Breast J. 2010;16:233–9.PubMedCrossRef
9.
Zurück zum Zitat Yuen S, Uematsu T, Kasami M, et al. Breast carcinomas with strong high-signal intensity on T2-weighted MR images: pathological characteristics and differential diagnosis. J Magn Reson Imaging. 2007;25:502–10.PubMedCrossRef Yuen S, Uematsu T, Kasami M, et al. Breast carcinomas with strong high-signal intensity on T2-weighted MR images: pathological characteristics and differential diagnosis. J Magn Reson Imaging. 2007;25:502–10.PubMedCrossRef
10.
Zurück zum Zitat Uematsu T, Kasami M, Yuen S. Triple-negative breast cancer: correlation between MR imaging and pathologic findings. Radiology. 2009;250:638–47.PubMedCrossRef Uematsu T, Kasami M, Yuen S. Triple-negative breast cancer: correlation between MR imaging and pathologic findings. Radiology. 2009;250:638–47.PubMedCrossRef
11.
Zurück zum Zitat Kawashima H, Kobayashi-Yoshida M, Matsui O, Zen Y, Suzuki M, Inokuchi M. Peripheral hyperintense pattern on T2-weighted magnetic resonance imaging (MRI) in breast carcinoma: correlation with early peripheral enhancement on dynamic MRI and histopathologic findings. J Magn Reson Imaging. 2010;32:1117–23.PubMedCrossRef Kawashima H, Kobayashi-Yoshida M, Matsui O, Zen Y, Suzuki M, Inokuchi M. Peripheral hyperintense pattern on T2-weighted magnetic resonance imaging (MRI) in breast carcinoma: correlation with early peripheral enhancement on dynamic MRI and histopathologic findings. J Magn Reson Imaging. 2010;32:1117–23.PubMedCrossRef
12.
Zurück zum Zitat Malich A, Fischer DR, Wurdinger S, et al. Potential MRI interpretation model: differentiation of benign from malignant breast masses. Am J Roentgenol. 2005;185:964–70.CrossRef Malich A, Fischer DR, Wurdinger S, et al. Potential MRI interpretation model: differentiation of benign from malignant breast masses. Am J Roentgenol. 2005;185:964–70.CrossRef
13.
Zurück zum Zitat Dietzel M, Baltzer PA, Vag T, et al. Application of breast MRI for prediction of lymph node metastases—systematic approach using 17 individual descriptors and a dedicated decision tree. Acta Radiol. 2010;51:885–94.PubMedCrossRef Dietzel M, Baltzer PA, Vag T, et al. Application of breast MRI for prediction of lymph node metastases—systematic approach using 17 individual descriptors and a dedicated decision tree. Acta Radiol. 2010;51:885–94.PubMedCrossRef
14.
Zurück zum Zitat Uematsu T. MRI findings of inflammatory breast cancer, locally advanced breast cancer, and acute mastitis: T2-weighted images can increase the specificity of inflammatory breast cancer. Breast Cancer. 2012;19:289–94.PubMedCrossRef Uematsu T. MRI findings of inflammatory breast cancer, locally advanced breast cancer, and acute mastitis: T2-weighted images can increase the specificity of inflammatory breast cancer. Breast Cancer. 2012;19:289–94.PubMedCrossRef
15.
Zurück zum Zitat Renz DM, Baltzer PA, Böttcher J, et al. Inflammatory breast carcinoma in magnetic resonance imaging: a comparison with locally advanced breast cancer. Acad Radiol. 2008;15:209–21.PubMedCrossRef Renz DM, Baltzer PA, Böttcher J, et al. Inflammatory breast carcinoma in magnetic resonance imaging: a comparison with locally advanced breast cancer. Acad Radiol. 2008;15:209–21.PubMedCrossRef
16.
Zurück zum Zitat Renz DM, Baltzer PA, Böttcher J, et al. Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis: a comparative study. Eur Radiol. 2008;18:2370–80.PubMedCrossRef Renz DM, Baltzer PA, Böttcher J, et al. Magnetic resonance imaging of inflammatory breast carcinoma and acute mastitis: a comparative study. Eur Radiol. 2008;18:2370–80.PubMedCrossRef
17.
Zurück zum Zitat Yasumura K, Ogawa K, Ishikawa H, Takeshita T, Nakagawa Y, Osamura RY. Inflammatory carcinoma of the breast: characteristic findings of MR imaging. Breast Cancer. 1997;4:161–9.PubMedCrossRef Yasumura K, Ogawa K, Ishikawa H, Takeshita T, Nakagawa Y, Osamura RY. Inflammatory carcinoma of the breast: characteristic findings of MR imaging. Breast Cancer. 1997;4:161–9.PubMedCrossRef
18.
Zurück zum Zitat Uematsu T, Kasami M, Watanabe J. Can T2-weighted 3-T breast MRI predict clinically occult inflammatory breast cancer before pathological examination? A single-center experience. Breast Cancer. 2012. [Epub ahead of print]. Uematsu T, Kasami M, Watanabe J. Can T2-weighted 3-T breast MRI predict clinically occult inflammatory breast cancer before pathological examination? A single-center experience. Breast Cancer. 2012. [Epub ahead of print].
19.
Zurück zum Zitat American College of Radiology. Breast imaging reporting and data system (BI-RADS). 4th ed. Reston: American College of Radiology; 2003. American College of Radiology. Breast imaging reporting and data system (BI-RADS). 4th ed. Reston: American College of Radiology; 2003.
20.
Zurück zum Zitat Abe H, Schmidt RA, Kulkarni K, Sennett CA, Mueller JS, Newstead GM. Axillary lymph nodes suspicious for breast cancer metastasis: sampling with US-guided 14-gauge core-needle biopsy—clinical experience in 100 patients. Radiology. 2009;250:41–9.PubMedCrossRef Abe H, Schmidt RA, Kulkarni K, Sennett CA, Mueller JS, Newstead GM. Axillary lymph nodes suspicious for breast cancer metastasis: sampling with US-guided 14-gauge core-needle biopsy—clinical experience in 100 patients. Radiology. 2009;250:41–9.PubMedCrossRef
21.
Zurück zum Zitat Kurosumi M, Akashi-Tanaka S, Akiyama F, et al. Histopathological criteria for assessment of therapeutic response in breast cancer (2007 version). Breast Cancer. 2008;15:5–7.PubMedCrossRef Kurosumi M, Akashi-Tanaka S, Akiyama F, et al. Histopathological criteria for assessment of therapeutic response in breast cancer (2007 version). Breast Cancer. 2008;15:5–7.PubMedCrossRef
23.
Zurück zum Zitat Hasebe T, Yamauchi C, Iwasaki M, Ishii G, Wada N, Imoto S. Grading system for lymph vessel tumor emboli for prediction of the outcome of invasive ductal carcinoma of the breast. Hum Pathol. 2008;39:427–36.PubMedCrossRef Hasebe T, Yamauchi C, Iwasaki M, Ishii G, Wada N, Imoto S. Grading system for lymph vessel tumor emboli for prediction of the outcome of invasive ductal carcinoma of the breast. Hum Pathol. 2008;39:427–36.PubMedCrossRef
24.
Zurück zum Zitat Uematsu T, Kasami M, Watanabe J, et al. Is lymphovascular invasion degree one of the important factors to predict neoadjuvant chemotherapy efficacy in breast cancer? Breast Cancer. 2011;18:309–13.PubMedCrossRef Uematsu T, Kasami M, Watanabe J, et al. Is lymphovascular invasion degree one of the important factors to predict neoadjuvant chemotherapy efficacy in breast cancer? Breast Cancer. 2011;18:309–13.PubMedCrossRef
25.
Zurück zum Zitat Tamura N, Hasebe T, Okada N, et al. Tumor histology in lymph vessels and lymph nodes for the accurate prediction of outcome among breast cancer patients treated with neoadjuvant chemotherapy. Cancer Sci. 2009;100:1823–33.PubMedCrossRef Tamura N, Hasebe T, Okada N, et al. Tumor histology in lymph vessels and lymph nodes for the accurate prediction of outcome among breast cancer patients treated with neoadjuvant chemotherapy. Cancer Sci. 2009;100:1823–33.PubMedCrossRef
26.
Zurück zum Zitat Bevilacqua JL, Kattan MW, Fey JV, Cody HS 3rd, Borgen PI, Van Zee KJ. Doctor, what are my chances of having a positive sentinel node? A validated nomogram for risk estimation. J Clin Oncol. 2007;25:3670–9.PubMedCrossRef Bevilacqua JL, Kattan MW, Fey JV, Cody HS 3rd, Borgen PI, Van Zee KJ. Doctor, what are my chances of having a positive sentinel node? A validated nomogram for risk estimation. J Clin Oncol. 2007;25:3670–9.PubMedCrossRef
27.
Zurück zum Zitat Xiong QH, Valero V, Kau V, et al. Female patients with breast carcinoma age 30 years and younger have a poor prognosis—the M. D. Anderson Cancer Center experience. Cancer. 2001;92:2523–8.PubMedCrossRef Xiong QH, Valero V, Kau V, et al. Female patients with breast carcinoma age 30 years and younger have a poor prognosis—the M. D. Anderson Cancer Center experience. Cancer. 2001;92:2523–8.PubMedCrossRef
28.
Zurück zum Zitat Yildirim E, Dalgic T, Berberoglu U. Prognostic significance of young age in breast cancer. J Surg Oncol. 2000;74:267–72.PubMedCrossRef Yildirim E, Dalgic T, Berberoglu U. Prognostic significance of young age in breast cancer. J Surg Oncol. 2000;74:267–72.PubMedCrossRef
29.
Zurück zum Zitat Warwick J, Tabar L, Vitak B, Duffy SW. Time-dependent effects on survival in breast carcinoma: results of 20 years of follow-up from the Swedish Two-County Study. Cancer. 2004;100:1331–6.PubMedCrossRef Warwick J, Tabar L, Vitak B, Duffy SW. Time-dependent effects on survival in breast carcinoma: results of 20 years of follow-up from the Swedish Two-County Study. Cancer. 2004;100:1331–6.PubMedCrossRef
30.
Zurück zum Zitat Vandorpe T, Smeets A, Van Calster B, et al. Lobular and non-lobular breast cancers differ regarding axillary lymph node metastasis: a cross-sectional study on 4,292 consecutive patients. Breast Cancer Res Treat. 2011;128:429–35.PubMedCrossRef Vandorpe T, Smeets A, Van Calster B, et al. Lobular and non-lobular breast cancers differ regarding axillary lymph node metastasis: a cross-sectional study on 4,292 consecutive patients. Breast Cancer Res Treat. 2011;128:429–35.PubMedCrossRef
31.
Zurück zum Zitat Weinstein S, Rosen M. Breast MR imaging: current indications and advanced imaging techniques. Radiol Clin N Am. 2010;48:1013–42.PubMedCrossRef Weinstein S, Rosen M. Breast MR imaging: current indications and advanced imaging techniques. Radiol Clin N Am. 2010;48:1013–42.PubMedCrossRef
32.
Zurück zum Zitat Uematsu T, Kasami M, Yuen S. Neoadjuvant chemotherapy for breast cancer: correlation between the baseline MR imaging findings and responses to therapy. Eur Radiol. 2010;20:2315–22.PubMedCrossRef Uematsu T, Kasami M, Yuen S. Neoadjuvant chemotherapy for breast cancer: correlation between the baseline MR imaging findings and responses to therapy. Eur Radiol. 2010;20:2315–22.PubMedCrossRef
33.
Zurück zum Zitat Baltzer PA, Freiberg C, Beger S, et al. Clinical MR-mammography: are computer-assisted methods superior to visual or manual measurements for curve type analysis? A systemic approach. Acad Radiol. 2009;16:1070–6.PubMedCrossRef Baltzer PA, Freiberg C, Beger S, et al. Clinical MR-mammography: are computer-assisted methods superior to visual or manual measurements for curve type analysis? A systemic approach. Acad Radiol. 2009;16:1070–6.PubMedCrossRef
34.
Zurück zum Zitat Kinkel K, Helbich TH, Esserman LJ, et al. Dynamic high-spatial-resolution MR imaging of suspicious breast lesions: diagnostic criteria and interobserver variability. Am J Roentgenol. 2000;175:35–43.CrossRef Kinkel K, Helbich TH, Esserman LJ, et al. Dynamic high-spatial-resolution MR imaging of suspicious breast lesions: diagnostic criteria and interobserver variability. Am J Roentgenol. 2000;175:35–43.CrossRef
35.
Zurück zum Zitat Mussurakis S, Buckley DL, Coady AM, Turnbull LW, Horsman A. Observer variability in the interpretation of contrast enhanced MRI of the breast. Br J Radiol. 1996;69:1009–16.PubMedCrossRef Mussurakis S, Buckley DL, Coady AM, Turnbull LW, Horsman A. Observer variability in the interpretation of contrast enhanced MRI of the breast. Br J Radiol. 1996;69:1009–16.PubMedCrossRef
36.
Zurück zum Zitat Mussurakis S, Buckley DL, Horsman A. Dynamic MRI of invasive breast cancer: assessment of three region-of-interest analysis methods. J Comput Assist Tomogr. 1997;21:431–8.PubMedCrossRef Mussurakis S, Buckley DL, Horsman A. Dynamic MRI of invasive breast cancer: assessment of three region-of-interest analysis methods. J Comput Assist Tomogr. 1997;21:431–8.PubMedCrossRef
37.
Zurück zum Zitat Vag T, Baltzer PA, Dietzel M, et al. Kinetic analysis of lesions without mass effect on breast MRI using manual and computer-assisted methods. Eur Radiol. 2011;21:893–8.PubMedCrossRef Vag T, Baltzer PA, Dietzel M, et al. Kinetic analysis of lesions without mass effect on breast MRI using manual and computer-assisted methods. Eur Radiol. 2011;21:893–8.PubMedCrossRef
Metadaten
Titel
Is evaluation of the presence of prepectoral edema on T2-weighted with fat-suppression 3 T breast MRI a simple and readily available noninvasive technique for estimation of prognosis in patients with breast cancer?
verfasst von
Takayoshi Uematsu
Masako Kasami
Junichiro Watanabe
Publikationsdatum
01.11.2014
Verlag
Springer Japan
Erschienen in
Breast Cancer / Ausgabe 6/2014
Print ISSN: 1340-6868
Elektronische ISSN: 1880-4233
DOI
https://doi.org/10.1007/s12282-013-0440-z

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