Key points
Introduction
Materials and methods
Patients
Imaging technique
Imaging interpretation
Histologic evaluation and pathogenic mutation analysis
Statistical analysis
Results
Gene mutations status
Gene | Mutation | Age at diagnosis | Family history | Mutation type |
---|---|---|---|---|
BRCA1 | c.3359_3363delTTAAT | 48 | Sister | frameshift |
c.5470_5477delATTGGGCA | 30 | Aunt | frameshift | |
c.5136G > Aa | 29 | Mother | nonsense | |
c.5153-1G > Aa | 47 | Sister | splice-site variants | |
chr17:41246509delG | 41 | Mother | frameshift | |
chr17:41226484insC | 44 | Sister | frameshift | |
c.5470_5477delATTGGGCA | 53 | Aunt | frameshift | |
chr17:41226455delG | 49 | Mother | frameshift | |
c.2138C > G | 34 | Mother, Aunt | nonsense | |
BRCA2 | chr13:32913702DelTACT | 51 | Mother | frameshift |
chr13:32914936InsTA | 41 | Sister | frameshift | |
BAP1 | chr3:52440911InsC | 26 | Mother | frameshift |
BRIP1 | chr17:59793425C > A | 41 | Sister | splice-site variants |
MSH6 | chr2:48010546delC | 49 | Mother | frameshift |
ATM | c.2414C > T | 32 | Aunt | nonsense |
Gene | Mutation | Age at diagnosis | Family history | Mutation type |
---|---|---|---|---|
BRIP1 | chr17:59938867C > A | 75 | Sister | missense |
BRCA1 | c.154C > T | 46 | Sister | missense |
PALB2 | c.3296C > T | 43 | Sister | missense |
ATM | c.8716G > C | 47 | Sister | missense |
c.275A > C | 49 | Mother | missense | |
c.125A > G | 43 | Aunt | missense | |
c.8495G > A | 38 | Mother | missense | |
CDH1 | c.1888C > G | 45 | Sister | missense |
MSH2 | c.970C > T | 42 | Mother | missense |
c.14C > A | 63 | Mother | missense | |
TP53 | c.733G > A | 32 | Mother | missense |
Clinicopathological and radiologic features associated with pathogenic mutations
Variable | Pathogenic N = 17 | No Pathogenic N = 47 | No. of all | P value |
---|---|---|---|---|
Age | ||||
< 40 years | 7 (41.2%) | 7 (14.9%) | 14 (21.9%) | 0.039 |
≥ 40 years | 10 (58.8%) | 40 (85.1%) | 50 (78.1%) | |
Histopathological type | ||||
Ductal carcinoma in situ | 1 (5.9%) | 7 (14.9%) | 8(12.5%) | 0.434 |
Invasive ductal carcinoma | 16 (94.1%) | 40 (85.1%) | 56 (87.5%) | |
Tumor size | ||||
T1 | 8 (47.1) | 15 (31.9) | 23 (35.9) | 0.534 |
T2 | 7(41.2) | 26 (55.3) | 33 (51.6) | |
T3 | 2 (11.8) | 6 (12.8) | 8 (12.5) | |
Node metastasis | ||||
N- | 10 (58.8) | 34 (72.3) | 44 (68.8) | 0.365 |
N + | 7 (41.2) | 13 (27.7) | 20 (31.2) | |
Recurrence or Metastasis | ||||
Yes | 5 (29.4) | 3 (6.4) | 8 (12.5) | 0.014 |
No | 12 (70.6) | 44 (93.6) | 56 (87.5) | |
Biologic feature | ||||
unfavorable | 10(58.8) | 6(12.8) | 16(25.0) | 0.000 |
Intermediate/ favorable | 7(41.2) | 41(87.2) | 48(75.0) | |
Nuclear grade | ||||
Low/Intermediate | 11 (64.7) | 43(91.5) | 54 (84.4) | 0.017 |
high | 6 (35.3) | 4 (8.5) | 10(15.6) | |
ER | ||||
ER- | 10 (58.8) | 9(19.1) | 19 (29.7) | 0.004 |
ER + | 7 (41.2) | 38 (80.9) | 45 (70.3) | |
PR | ||||
PR- | 10(58.8) | 10(21.3) | 20(31.2) | 0.007 |
PR + | 7(41.2) | 37 (78.7) | 44 (68.8) | |
HER2 | ||||
HER2- | 13 (76.5) | 29 (61.7) | 42 (65.6) | 0.375 |
HER2 + | 4 (23.5) | 18 (38.3) | 22 (34.4) | |
p53 | ||||
p53- | 5 (29.4) | 24 (51.1) | 29 (45.3) | 0.160 |
p53 + | 12 (70.6) | 23 (48.9) | 35 (54.7) | |
Ki67 | ||||
Ki67- | 1 (5.9) | 13 (27.7) | 14 (21.9) | 0.057 |
Ki67 + | 16 (94.1) | 34 (72.3) | 50 (78.1) | |
Molecular subtype | ||||
Luminal A | 3 (17.6) | 15 (31.9) | 18 (28.1) | |
Luminal B | 5 (29.5) | 24 (51.1) | 29 (45.3) | 0.000 |
HER2 over-expression | 0 (0.0) | 5 (10.6) | 5 (7.8) | |
Triple negative | 9 (52.9) | 3 (6.4) | 12 (18.8) | |
Triple negative | ||||
No | 8 (47.1) | 44 (93.6) | 52 (81.2) | 0.000 |
Yes | 9 (52.9) | 3 (6.4) | 12 (18.8) |
Variable | Pathogenic N = 17 | No Pathogenic N = 47 | No. of all | P value |
---|---|---|---|---|
MG | ||||
Breast density | ||||
Non-dense | 1(5.9) | 17(36.2) | 18(28.1) | 0.025 |
Dence | 16(94.1) | 30(63.8) | 46(71.9) | |
Lesion type | ||||
Calcification | 3 (17.6) | 5 (10.6) | 8 (12.5) | 0.722 |
Mass | 7 (41.2) | 19 (40.4) | 26 (40.6) | |
Asymmetry/ Distortion | 7(41.2) | 23 (48.9) | 30 (46.9) | |
MRI | ||||
Lesion type | ||||
Mass | 17(100.0) | 37 (78.7) | 54 (84.4) | 0.038 |
Nonmass | 0(0.0) | 10 (21.3) | 10 (15.6) | |
Internal enhancement pattern | ||||
Heterogeneous mass-enhancement | 4 (23.5) | 30 (63.8) | 34 (53.2) | 0.000 |
Rim mass-enhancement | 13 (76.5) | 7 (14.9) | 20 (31.2) | |
Line/segmental nonmass-enhancement | 0 (0.0%) | 10 (21.3) | 10 (15.6) | |
Shape | ||||
Regular | 6 (35.3) | 10 (21.3) | 16 (25.0) | 0.253 |
Irregular | 11 (64.7) | 37 (78.7) | 48 (75.0) | |
Spiculated margin | ||||
Yes | 0 (0.0) | 16 (34.0) | 16 (25.0) | 0.005 |
No | 17 (100.0) | 31 (66.0) | 48 (75.0) | |
Central necrosis | ||||
Yes | 6 (35.3) | 4 (8.5) | 10 (15.6) | 0.009 |
No | 11 (64.7) | 43 (91.5) | 54 (84.4) | |
Peritumoral edema | ||||
Yes | 4 (23.5) | 10 (21.3) | 14 (21.9) | 0.847 |
No | 13 (76.5) | 37 (78.7) | 50 (78.1) | |
Tumor localization | ||||
Edge | 14 (82.4) | 36 (76.6) | 50 (78.1) | 0.623 |
Central | 3 (17.6) | 11 (23.4) | 11 (21.9) |
Clinico-pathological and radiologic features associated with disease recurrence or metastasis
Variable | Recurrence or Metastasis N = 8 | No Recurrence or Metastasis N = 56 | No. of all | P value |
---|---|---|---|---|
Age | ||||
< 40 years | 3 (37.5) | 11 (19.6) | 14 (21.9) | 0.253 |
≥ 40 years | 5 (62.5) | 45 (80.4) | 50 (78.1) | |
Histopathological type | ||||
Ductal carcinoma in situ | 1 (12.5) | 7 (87.5) | 8(12.5) | 1.000 |
Invasive ductal carcinoma | 7 (12.5) | 49 (87.5) | 56 (87.5) | |
Tumor size | ||||
T1 | 2 (25.0) | 21 (37.5) | 23 (35.9) | 0.073 |
T2 | 3 (37.5) | 30 (53.6) | 33 (51.6) | |
T3 | 3 (37.5) | 5 (8.9) | 8 (12.5) | |
Node metastatic | ||||
N- | 5 (62.5) | 39 (69.6) | 44 (68.8) | 0.683 |
N + | 3 (37.5) | 17 (30.4) | 20 (31.2) | |
Biologic feature | ||||
unfavorable | 4(50.0) | 12(21.4) | 16(25.0) | 0.081 |
Intermediate/ favorable | 4(50.0) | 44(78.6) | 48(75.0) | |
Nuclear grade | ||||
Low/Intermediate | 4 (50.0) | 50(89.3) | 54 (84.4) | 0.004 |
high | 4 (50.0) | 6 (10.7) | 10(15.6) | |
ER | ||||
ER- | 5 (62.5) | 14 (25.0) | 19 (29.7) | 0.030 |
ER + | 3 (37.5) | 42 (75.0) | 45 (70.3) | |
PR | ||||
PR- | 5 (62.5) | 15 (26.8) | 20 (31.2) | 0.041 |
PR + | 3 (37.5) | 41 (73.2) | 44 (68.8) | |
HER2 | ||||
HER2- | 7 (87.5) | 35 (62.5) | 42 (65.6) | 0.164 |
HER2 + | 1 (12.5) | 21 (37.5) | 22 (34.4) | |
p53 | ||||
p53- | 1 (12.5) | 28 (50.0) | 29 (45.3) | 0.046 |
p53 + | 7 (87.5) | 28 (50.0) | 35 (54.7) | |
Ki67 | ||||
Ki67- | 0 (0.0) | 14 (25.0) | 14 (21.9) | 0.110 |
Ki67 + | 8(100.0) | 42 (75.0) | 50 (78.1) | |
Molecular substype | ||||
Luminal A | 0 (0.0) | 18 (32.1) | 18 (28.1) | 0.052 |
Luminal B | 3 (37.5) | 26 (46.4) | 29 (45.3) | |
HER2 over-expression | 1 (12.5) | 4 (7.2) | 5 (7.8) | |
Triple negative | 4 (50.0) | 8 (14.3) | 12 (18.8) | |
Triple negative | ||||
No | 4 (50.0) | 48 (85.7) | 52 (81.2) | 0.015 |
Yes | 4 (50.0) | 8 (14.3) | 12 (18.8) |
Variable | Recurrence or Metastasis N = 8 | No Recurrence or Metastasis N = 56 | No. of all | P value |
---|---|---|---|---|
MG | ||||
Breast density | ||||
Non-dense | 1 (12.5) | 17 (30.4) | 18(28.1) | 0.293 |
Dense | 7 (87.5) | 39 (69.6) | 46(71.9) | |
Lesion type | ||||
Calcification | 1 (12.5) | 7 (12.5) | 8 (12.5) | 0.831 |
Mass | 3 (37.5) | 22 (39.3) | 26 (40.6) | |
Asymmetry/ Distortion | 4 (50.0) | 27 (48.2) | 30 (46.9) | |
MRI | ||||
Lesion type | ||||
Mass | 6(75.0) | 48 (85.7) | 54 (84.4) | 0.435 |
Nonmass | 2(25.0) | 8 (14.3) | 10 (15.6) | |
Internal enhancement pattern | ||||
Heterogeneous mass-enhancement | 1 (12.5) | 33 (58.9) | 34 (53.1) | 0.045 |
Rim mass-enhancement | 5 (62.5) | 15 (26.8) | 20 (31.2) | |
Line/segmental nonmass-enhancement | 2 (25.0) | 8 (14.3) | 10 (15.6) | |
Shape | ||||
Regular | 4 (50.0) | 12 (21.4) | 16 (25.0) | 0.081 |
Irregular | 4 (50.0) | 44 (78.6) | 48 (75.0) | |
Spiculated margin | ||||
Yes | 0 (0.0) | 16 (28.6) | 16 (25.0) | 0.081 |
No | 8 (100.0) | 40 (71.4) | 48 (75.0) | |
Central necrosis | ||||
Yes | 6(75.0) | 4 (7.1) | 10 (15.6) | 0.000 |
No | 2(25.0) | 52 (92.9) | 54 (84.4) | |
Peritumoral edema | ||||
Yes | 3 (37.5) | 11 (19.6) | 14 (21.9) | 0.253 |
No | 5 (62.5) | 45 (80.4) | 50 (78.1) | |
Tumor localization | ||||
Edge | 6 (75.0) | 44 (78.6) | 50 (78.1) | 0.819 |
Central | 2 (25.0) | 12 (21.4) | 14 (21.9) |
Multivariable analyses of predicting pathogenic mutations and disease recurrence or metastasis and ROC analyses
Variable | Odds ratio | 95%CI | P value |
---|---|---|---|
Age | |||
< 40 years | Reference | NA | 0.418 |
≥ 40 years | 0.914 | 0.736–1.134 | |
Recurrence or Metastasis | |||
No | Reference | NA | 0.039 |
Yes | 1.402 | 1.024–1.916 | |
Biologic feature | |||
unfavorable | Reference | NA | 0.000 |
Intermediate/ favorable | 0.409 | 0.259–0.647 | |
Nuclear grade | |||
Low/Intermediate | Reference | NA | 0.045 |
high | 0.736 | 0.551–0.986 | |
ER | |||
ER + | Reference | NA | 0.416 |
ER- | 1.368 | 0.646–2.896 | |
PR | |||
PR + | Reference | NA | 0.304 |
PR- | 1.399 | 0.742–2.642 | |
Molecular substype | |||
Non-Triple negative | Reference | NA | 0.634 |
Triple negative | 1.099 | 0.721–1.676 | |
Breast density | |||
Non-dense | Reference | NA | 0.005 |
Dense | 1.315 | 1.093–1.582 | |
MRI Lesion type | |||
Nonmass | Reference | NA | 0.000 |
Mass | 2.705 | 1.739–4.207 | |
Internal enhancement pattern | |||
Other enhancement types | Reference | NA | 0.004 |
Rim mass-enhancement | 1.404 | 1.121–1.758 | |
Spiculated margin | |||
Yes | Reference | NA | 0.049 |
No | 0.803 | 0.649–0.994 | |
Central necrosis | |||
No | Reference | NA | 0.388 |
Yes | 0.875 | 0.649–1.181 |
Variable | Odds ratio | 95%CI | P value |
---|---|---|---|
Nuclear grade | |||
Low/Intermediate | Reference | NA | 0.056 |
high | 1.242 | 0.998–1.544 | |
ER | |||
ER + | Reference | NA | 0.888 |
ER- | 1.042 | 0.590–1.839 | |
PR | |||
PR + | Reference | NA | 0.920 |
PR- | 0.973 | 0.573–1.653 | |
p53 | |||
p53- | Reference | NA | 0.348 |
p53 + | 1.069 | 0.930–1.230 | |
Molecular subtype | |||
Non-Triple negative | Reference | NA | 0.498 |
Triple negative | 0.909 | 0.691–1.196 | |
Internal enhancement pattern | |||
Other enhancement types | Reference | NA | 0.439 |
Rim mass-enhancement | 1.037 | 0.946–1.138 | |
Central necrosis | |||
No | Reference | NA | 0.000 |
Yes | 1.671 | 1.357–2.056 |