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• Clinical Article •
The value of dynamic contrast enhancement and diffusion weighted imaging in diagnosis and prediction of breast cancer recurrence
ZHANG Hui  SHAN Chun-hui  WANG Yong 

DOI:10.12015/issn.1674-8034.2017.11.006.


[Abstract] Objective: Assess the value of MRI dynamic contrast enhancement (DCE-MRI) and diffusion-weighted imaging (DWI) in diagnosing and predicting early and late breast cancer recurrence.Materials and methods: There were 78 breast cancer patients in Hebei general hospital were examed by DCE-MRI and DWI scan,between January 2011 and June 2014. All of these patients were examed by breast mammography or ultrasound before our exam and had been confirmed by pathology. We compared the early recurrence after surgery (2 years) or less and late recurrence [(>2 years) after the surgery] in patients with MRI characteristics [including: background parenchymal enhancement (BPE), mass of substantial enhancement patterns, the vascular distribution of the whole breast, dynamic enhancement curve type, apparent diffusion coefficient (ADC) value] and clinical pathological variables. In this paper, Cox proportional hazard regression analysis was performed to evaluate independent risk factors for early and late recurrence.Results: In the MRI examination of breast cancer, the distribution of total breast blood vessels was significantly correlated with the early recurrence. Moderate or obvious BPE and rim enhancement, which is associated with late recurrence.In the diffusion weighted imaging, the proportion of ADC values <1.20×10-3 mm2/s were significantly higher in the early recurrence cases than in the later recurrence (P<0.05). The clinical pathological variables associated with early recurrence were estrogen receptor (ER) negative (HR was 0.45, 95% confidence interval was 0.26—0.93).Conclusions: In DCE-MRI, prominent ipsilateral whole-breast vascularity, moderate or marked BPE, and rim enhancement could be useful for predicting recurrence timing in patients with breast cancer. MRI dynamic contrast enhancement examination and dynamic enhancement curve type and the value of ADC can effectively diagnose and predict the recurrence of breast cancer patients.
[Keywords] Breast cancer；Dynamic contrast enhancement；Tumor recurrence；Diffusion-weighted imaging

ZHANG Hui* Department of Radiology, Hebei General Hospital, Shijiazhuang 050051, China

SHAN Chun-hui Department of Radiology, Hebei General Hospital, Shijiazhuang 050051, China

WANG Yong Department of Radiology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China

*Correspondence to: Zhang H, E-mail: wszzzhui@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  Project of Key Project of Medical Science of Hebei Province No. 20110229
Received  2017-07-17
Accepted  2017-10-09
DOI: 10.12015/issn.1674-8034.2017.11.006
DOI:10.12015/issn.1674-8034.2017.11.006.

[1]
Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012. CA Cancer J Clin, 2015, 65(2): 87-108.
[2]
Lowery AJ, Kell MR, Glynn RW, et al. Locoregional recurrence after breast cancer surgery: a systematic review by receptor phenotype. Breast Cancer Res Treat, 2012, 133(3): 831-841.
[3]
Morris EA, Comstock CE, Lee CH, et al. ACR BI-RADS® magnetic resonance imaging//ACR BI-RADS® atlas, breast imaging reporting and data system. Reston: American College of Radiology, 2013.
[4]
Dietzel M, Baltzer PA, Vag T, et al. The adjacent vessel sign on breast MRI: new data and a subgroup analysis for 1084 histologically verified cases. Korean J Radiol, 2010, 11(2): 178-186.
[5]
Sardanelli F, Iozzelli A, Fausto A, et al. Gadobenate dimeglumine-enhanced MR imaging breast vascular maps: association between invasive cancer and ipsilateral increased vascularity. Radiology, 2005, 235(3): 791-797.
[6]
Kang DK, Kim EJ, Kim HS, et al. Correlation of whole-breast vascularity with ipsilateral breast cancers using contrast-enhanced MDCT. AJR Am J Roentgenol, 2008, 190(2): 496-504.
[7]
Mansell J, Monypenny IJ, Skene AI, et al. Patterns and predictors of early recurrence in postmenopausal women with estrogen receptor-positive early breast cancer. Breast Cancer Res Treat, 2009, 117(1): 91-98.
[8]
Song WJ, Kim KI, Park SH, et al. The risk factors influencing between the early and late recurrence in systemic recurrent breast cancer. J Breast Cancer, 2012, 15(2): 218-223.
[9]
Nishimura R, Osako T, Nishiyama Y, et al. Evaluation of factors related to late recurrence. Later than 10 years after the initial treatment: in primary breast cancer. Oncology, 2013, 85(2):100-110.
[10]
Kennecke H, McArthur H, Olivotto IA, et al. Risk of early recurrence among postmenopausal women with estrogen receptor-positive early breast cancer treated with adjuvant tamoxifen. Cancer, 2008, 112(7):1437-1444.
[11]
Jonat W, Gnant M, Boccardo F, et al. Effectiveness of switching from adjuvant tamoxifen to anastrozole in postmenopausal women with hormone-sensitive early-stage breast cancer: a meta-analysis. Lancet Oncol, 2006, 7(12): 991-996.
[12]
Senkus E, Kyriakides S, Ohno S, et al. Primary breast cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol, 2015, 26(5): 218-230.
[13]
Joensuu K, Leidenius M, Kero M, et al. ER, PR, HER2, Ki-67 and CK5 in early and late relapsing breast cancer-reduced CK5 expression in metastases. Breast Cancer (Auckland), 2013, 7(1):23-34.
[14]
Ahn SG, Lee HM, Cho SH, et al. The difference in prognostic factors between early recurrence and late recurrence in estrogen receptor-positive breast cancer: nodal stage differently impacts early and late recurrence. PloS One, 2013, 8(5): 635-640.
[15]
Gray RJ. Flexible methods for analyzing survival data using splines, with applications to breast cancer prognosis. J Am Stat Assoc, 1992,87(1): 942-951.
[16]
Westenend PJ, Meurs CJ, Damhuis RA. Tumour size and vascular invasion predict distant metastasis in stage I breast cancer. Grade distinguishes early and late metastasis. J Pathol, 2005, 58(2):196-201.
[17]
Jia ZZ, Shi W, Shi JL, et al. Comparison between perfusion computed tomography and dynamic contrast-enhanced magnetic resonance imaging in assessing glioblastoma microvasculature. Eur J Radiol, 2017, 87(12): 120-124.
[18]
Teifke A, Behr O, Schmidt M, et al. Dynamic MR imaging of breast lesions: correlation with microvessel distribution pattern and histologic characteristics of prognosis. Radiology, 2006, 239(2):351-360.
[19]
Lee SH, Cho N, Kim SJ, et al. Correlation between high resolution dynamic MR features and prognostic factors in breast cancer. Korean J Radiol, 2008, 9(1): 10-18.
[20]
Wu S, Zuley ML, Berg WA, et al. DCE-MRI background parenchymal enhancement quantified from an early versus delayed post-contrast sequence: association with breast cancer presence. Sci Rep, 2017, 7(1): 2115-2128.
[21]
Dhakal HP, Bassarova A, Naume B, et al. Breast carcinoma vascularity: a comparison of manual microvessel count and chalkley count. Histol Histopathol, 2009, 24(8): 1049-1059.
[22]
Han M, Kim TH, Kang DK, et al. Prognostic role of MRI enhancement features in patients with breast cancer: value of adjacent vessel sign and increased ipsilateral whole-breast vascularity. AJR Am J Roentgenol, 2012, 199(4): 921-928.
[23]
Narisada H, Aoki T, Sasaguri T, et al. Correlation between numeric gadolinium-enhanced dynamic MRI ratios and prognostic factors and histologic type of breast carcinoma. AJR Am J Roentgenol, 2006,187(2): 297-306.
[24]
Colpaert C, Vermeulen P, Jeuris W, et al. Early distant relapse in "node-negative" breast cancer patients is not predicted by occult axillary lymph node metastases, but by the features of the primary tumour. J Pathol, 2001, 193(4): 442-449.
[25]
Pereira FP, Martins G, Carvalhaes RV. Diffusion magnetic resonance imaging of the breast. Magn Reson Imaging Clin N Am, 2011, 19(1):95-110.
[26]
Thomassin-Naggara I, De Bazelaire C, Chopier J, et al. Diffusion-weighted MR imaging of the breast: advantages and pitfalls. Eur J Radiol, 2013, 82(3): 435-443.

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