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• Clinical Article •
The correlation between multiparametric MR imaging characteristics of breast cancer and axillary lymph node metastasis
XUE Mei  LI Jing  CHE Shunan  ZHAO Liyun  TIAN Yuan  GUO Ning  ZHOU Chunwu 

Cite this article as: Xue M, Li J, Che SN, et al. The correlation between multiparametric MR imaging characteristics of breast cancer and axillary lymph node metastasis. Chin J Magn Reson Imaging, 2020, 11(7): 540-545. DOI:10.12015/issn.1674-8034.2020.07.013.


[Abstract] Objective: To explore the MR imaging features of breast tumor in correlation with axillary lymph node metastasis in breast cancer patients.Materials and Methods: Two hundred and sixteen patients with breast cancer were confirmed by surgery and pathology were retrospectively reviewed at our institution between January 2016 to December 2016. According to the postoperative pathological results, the patients were divided into axillary lymph node metastasis [ALNM (+)] and non-metastasis lymph node group [ALNM (-) ]. The MRI features of the primary breast cancer lesions were recorded by two experts. The MR image characters including: the corpus mamma patterns, background parenchymal enhancement, tumor size, tumor location, multifocality, signal characteristics of T2WI, ADC value, enhancement pattern, time-intensity curve (TIC) curve type and the axillary lymph node status. The continuous variables was studied using Mann Whitney U test, and The categorical variables was studied using χ2 tests and Fisher exact test.Results: The sensitivity, specificity and accuracy of MRI for metastatic axillary lymph nodes was 63.64%, 94.41%, 86.57%, respectively. Statistical differences were found between ALNM (+) group and ALNM (-) group in tumor location, tumor size, ADC value, multifocality. There were no statistical differences between ALNM (+) group and ALNM (-) group in age, the corpus mamma patterns, background parenchymal enhancement, signal characteristics of T2WI, enhancement pattern, TIC curve type. Drawing the ROC curve according to the tumor size and ADC values, the AUC was 0.686 (P=0.000, 95% CI=0.609-0.762), 0.771 (P=0.000, 95% CI=0.704—0.838). When the threshold of tumor size was set at 1.95 cm, the diagnostic sensitivity and specificity were 70.9% and 55.9%, respectively. when the threshold of ADC was set at 1.125×10-3 mm2/s, the diagnostic sensitivity and specificity were 80% and 60.9%, respectively.Conclusions: Preoperative MRI can effectively evaluate axillary lymph node metastasis of breast cancer. Breast tumor location, size, multifocality and ADC value have a good correlation with axillary metastasis lymph nodes.
[Keywords] breast neoplasms；lymph nodes；neoplasm metastasis；Axilla；magnetic resonance imaging

XUE Mei Imaging Diagnostic Department, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

LI Jing* Imaging Diagnostic Department, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

CHE Shunan Imaging Diagnostic Department, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

ZHAO Liyun Imaging Diagnostic Department, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

TIAN Yuan Imaging Diagnostic Department, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

GUO Ning Imaging Diagnostic Department, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

ZHOU Chunwu Imaging Diagnostic Department, National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China

*Correspondence to: Li J, E-mail: dr.lijing@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  Beijing Hope Run Special Fund of Cancer Foundation of China No. LC2018A17
Received  2020-01-06
Accepted  2020-03-28
DOI: 10.12015/issn.1674-8034.2020.07.013
Cite this article as: Xue M, Li J, Che SN, et al. The correlation between multiparametric MR imaging characteristics of breast cancer and axillary lymph node metastasis. Chin J Magn Reson Imaging, 2020, 11(7): 540-545. DOI:10.12015/issn.1674-8034.2020.07.013.

[1]
Valente SA, Levine GM, Silverstein MJ, et al. Accuracy of predicting axillary lymph node positivity by physical examination, mammography, ultrasonography, and magnetic resonance imaging. Ann Surg Oncol, 2012, 19(6): 1825-1830.
[2]
An YS, Lee DH, Yoon JK, et al. Diagnostic performance of 18F-FDG PET/CT, ultrasonography and MRI detection of axillary lymph node metastasis in breast cancer patients. Nuklearmedizin, 2014, 53(3): 89-94.
[3]
Zhang YN, Wang CJ, Xu Y, et al. Sensitivity, specificity and accuracy of ultrasound in diagnosis of breast cancer metastasis to the axillary lymph nodes in Chinese patients. Ultrasound Med Biol, 2015, 41(7): 1835-1841.
[4]
Diepstraten SC, Sever AR, Buckens CF, et al. Value of preoperative ultrasound-guided axillary lymph node biopsy for preventing completion axillary lymph node dissection in breast cancer: a systematic review and Meta-analysis. Ann Surg Oncol, 2014, 21(1): 51-59.
[5]
D'Orsi CJ, Sickles EA, Mendelson EB, et al. ACR BI-RADS® atlas, breast imaging reporting and data system. Reston: American College of Radiology, 2013.
[6]
Mortellaro VE, Marshall J, Singer L, et al. Magnetic resonance imaging for axillary staging in patients with breast cancer. J Magn Reson Imaging, 2009, 30(2): 309-312.
[7]
Javid S, Segara D, Lotfi P, et al. Can breast MRI predict axillary lymph node metastasis in women undergoing neoadjuvant chemotherapy. Ann Surg Oncol, 2010, 17(7): 1841-1846.
[8]
Luciani A, Dao TH, Lapeyre M, et al. Simultaneous bilateral breast and high-resolution axillary MRI of patients with breast cancer: preliminary results. AJR Am J Roentgenol, 2004, 182(4): 1059-1067.
[9]
Sakorafas GH, Peros G, Cataliotti L, et al. Lymphedema following axillary lymph node dissection for breast cancer. Surg Oncol, 2006, 15(3): 153-165.
[10]
谢四梅，张安秦，朱彩霞．触诊及影像学检查对乳腺癌腋淋巴结转移状况预测价值探讨．中华肿瘤防治杂志, 2014, 15(4): 130-134.
[11]
Yoshihara E, Smeets A, Laenen A, et al. Predictors of axillary lymph node metastases in early breast cancer and their applicability in clinical practice. Breast, 2013, 22(3): 357-361.
[12]
Kim JY, Seo HB, Park S, et al. Early-stage invasive ductal carcinoma: Association of tumor apparent diffusion coefficient values with axillary lymph node metastasis. Eur J Radiol, 2015, 84(11): 2137-2143.
[13]
Han L, Zhu Y, Liu Z, Yu T, et al. Radiomic nomogram for prediction of axillary lymph node metastasis in breast cancer. Eur Radiol, 2019, 29(7): 3820-3829.
[14]
Guvenc I, Akay S, Ince S, et al. Apparent diffusion coefficient value in invasive ductal carcinoma at 3.0 tesla: is it correlated with prognostic factors? Br J Radiol, 2016, 89(1060): 20150614.
[15]
Tezcan Ş, Uslu N, Öztürk FU, et al. Diffusion-weighted imaging of breast cancer: correlation of the apparent diffusion coefficient value with pathologic prognostic factors. Eur J Breast Health, 2019, 15(4): 262-267.
[16]
张波，季德刚，李航，等．乳腺癌腋窝淋巴结转移危险因素分析及预测模型的建立．中华实验外科杂志, 2019, 5(36): 958-961.
[17]
焦得闯，乔江华，朱久，等. T1期乳腺癌腋窝淋巴结转移及乳腺癌特异生存的影响因素分析．中华医学杂志, 2018, 98(40): 3258-3262.
[18]
Yong G, Cai YQ, Cai ZL, et al. Differentiation of clinically benign and malignant breast lesions using diffusion-weighted imaging. J Magn. Reson Imaging, 2002, 16 (2): 172-178.
[19]
Miho IY, Shozo O, Shigenori S, et al. Relation between cancer cellularity and apparent diffusion coefficient values using diffusion-weighted magnetic resonance imaging in breast cancer. Radiat Med, 2008, 26 (4): 222-226.
[20]
Swaminathan V, Mythreye K, O'Brien ET, et al. Superfine mechanical stiffness grades metastatic potential in patient tumor cells and in cancer cell lines. Cancer Res, 2011, 71(15): 5075-5080.

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