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Correlation analysis of MRI features of breast and feasibility of breast conserving surgery
LIU Liangsheng  LIU Peifang  MA Wenjuan  ZHANG Yu  LI Yanbo  WANG Jiahui  LU Hong 

Cite this article as: LIU L S, LIU P F, MA W J, et al. Correlation analysis of MRI features of breast and feasibility of breast conserving surgery[J]. Chin J Magn Reson Imaging, 2024, 15(1): 43-47, 60. DOI:10.12015/issn.1674-8034.2024.01.007.


[Abstract] Objective To investigate the preoperative MRI features and clinicopathological features associated with breast conserving surgery (BCS) failure and success.Materials and Methods The data of patients who planned to undergo BCS and underwent preoperative MRI examination from March 2018 to May 2021 were retrospectively analyzed, and divided into failure group and success group according to whether convert to mastectomy. Image features collected included: size, right and left side, whether the mass was a mass, depth, amount of fibroglandular tissue, whether it was symmetrical, associated signs, background parenchymal enhancement (BPE), temporal intensity profile, T1 signal, and T2 signal. Clinicopathological features included patient age, human epidermal growth factor receptor 2 (HER-2), estrogen receptor (ER), progesterone receptor (PR), proliferation-marker Ki-67, molecular subtype, and intraductal carcinoma or not. Univariate and multivariate logistic regression were used to analyze the imaging features and clinicopathological features between the two groups, and differences were considered statistically significant at P<0.05.Results The sample sizes of the BCS failure and success groups were 47 and 91 respectively. Univariate and multivariate logistic regression analysis showed that BPE was significantly different between the two groups. Using BPE minimal reinforcement as a reference, there was no statistical difference between it and BPE mild reinforcement [dominance ratio (OR)=0.317, 95% confidence interval (CI): 0.374-6.552, P=0.654] There was a statistical difference between it and moderate enhancement (OR=1.674, 95% CI: 1.392-26.420, P=0.022) and heavy enhancement of BPE (OR=1.569, 95% CI: 1.128-25.809, P=0.044). However, there was no significant difference in other clinicopathological and imaging features between failure group and success group.Conclusions BPE has a certain correlation with the success of BCS, higher BPE levels suggest a greater likelihood of BCS failure, which may be used as an effective indicator for the feasibility analysis of preoperative MRI evaluation of BCS and the formulation of accurate surgical strategies.
[Keywords] cancer；breast cancer；breast conserving surgery；image features；magnetic resonance imaging

LIU Liangsheng   LIU Peifang   MA Wenjuan   ZHANG Yu   LI Yanbo   WANG Jiahui   LU Hong*  

Department of Breast Imaging Diagnosis, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Malignant Tumors, Tianjin Key Laboratory of Cancer Prevention and Treatment, Tianjin Clinical Research Center for Malignant Tumors, Ministry of Education Key Laboratory of Breast Cancer Prevention and Treatment, Tianjin 300060, China

Corresponding author: LU H, E-mail: luhong_tianjin@163.com

Conflicts of interest   None.

Received  2023-07-13
Accepted  2023-12-29
DOI: 10.12015/issn.1674-8034.2024.01.007
Cite this article as: LIU L S, LIU P F, MA W J, et al. Correlation analysis of MRI features of breast and feasibility of breast conserving surgery[J]. Chin J Magn Reson Imaging, 2024, 15(1): 43-47, 60. DOI:10.12015/issn.1674-8034.2024.01.007.

[1]
VERONESI U, BOYLE P, GOLDHIRSCH A, et al. Breast cancer[J]. Lancet, 2005, 365(9472): 1727-1741. DOI: 10.1016/S0140-6736(05)66546-4.
[2]
CHODOSH L A. Breast cancer: current state and future promise[J/OL]. Breast Cancer Res, 2011, 13(6): 113 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/22071145/. DOI: 10.1186/bcr3045.
[3]
WEBER W P, HAUG M, KURZEDER C, et al. Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy[J]. Breast Cancer Res Treat, 2018, 172(3): 523-537. DOI: 10.1007/s10549-018-4937-1.
[4]
ROSSI L, MAZZARA C, PAGANI O. Diagnosis and treatment of breast cancer in young women[J/OL]. Curr Treat Options Oncol, 2019, 20(12): 86 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/31776799/. DOI: 10.1007/s11864-019-0685-7.
[5]
KRISHNA K L, SRINATH B S, SANTOSH D, et al. A comparative study of perioperative techniques to attain negative margins and spare healthy breast tissue in breast conserving surgery[J]. Breast Dis, 2020, 39(3/4): 127-135. DOI: 10.3233/BD-200443.
[6]
MARTINEZ C, METERISSIAN S, SAIDI A, et al. Targeted intraoperative radiation therapy during breast-conserving surgery for patients with early stage breast cancer: a phase II single center prospective trial[J/OL]. Adv Radiat Oncol, 2023, 8(5): 101236 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/37408681/. DOI: 10.1016/j.adro.2023.101236.
[7]
KACZMARSKI K, WANG P Q, GILMORE R, et al. Surgeon re-excision rates after breast-conserving surgery: a measure of low-value care[J/OL]. J Am Coll Surg, 2019, 228(4): 504-512.e2 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/30703538/. DOI: 10.1016/j.jamcollsurg.2018.12.043.
[8]
CHAGPAR A B, KILLELEA B K, TSANGARIS T N, et al. A randomized, controlled trial of cavity shave margins in breast cancer[J]. N Engl J Med, 2015, 373(6): 503-510. DOI: 10.1056/NEJMoa1504473.
[9]
CORSI F, SORRENTINO L, BOSSI D, et al. Preoperative localization and surgical margins in conservative breast surgery[J/OL]. Int J Surg Oncol, 2013, 2013: 793819 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/23986868/. DOI: 10.1155/2013/793819.
[10]
MOON W K, NOH D Y, IM J G. Multifocal, multicentric, and contralateral breast cancers: bilateral whole-breast US in the preoperative evaluation of patients[J]. Radiology, 2002, 224(2): 569-576. DOI: 10.1148/radiol.2242011215.
[11]
ANDO T, ITO Y, IDO M, et al. Pre-operative planning using real-time virtual sonography, an MRI/ultrasound image fusion technique, for breast-conserving surgery in patients with non-mass enhancement on breast MRI: a preliminary study[J]. Ultrasound Med Biol, 2018, 44(7): 1364-1370. DOI: 10.1016/j.ultrasmedbio.2018.03.001.
[12]
GOMMERS J J J, DUIJM L E M, BULT P, et al. The impact of preoperative breast MRI on surgical margin status in breast cancer patients recalled at biennial screening mammography: an observational cohort study[J]. Ann Surg Oncol, 2021, 28(11): 5929-5938. DOI: 10.1245/s10434-021-09868-1.
[13]
GOH Y, CHOU C P, CHAN C W, et al. Impact of contrast-enhanced mammography in surgical management of breast cancers for women with dense breasts: a dual-center, multi-disciplinary study in Asia[J]. Eur Radiol, 2022, 32(12): 8226-8237. DOI: 10.1007/s00330-022-08906-0.
[14]
ÅHSBERG K, GARDFJELL A, NIMEUS E, et al. The PROCEM study protocol: added value of preoperative contrast-enhanced mammography in staging of malignant breast lesions-a prospective randomized multicenter study[J/OL]. BMC Cancer, 2021, 21(1): 1115 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/34663236/. DOI: 10.1186/s12885-021-08832-2.
[15]
LOBBES M B I, HEUTS E M, MOOSSDORFF M, et al. Contrast enhanced mammography (CEM) versus magnetic resonance imaging (MRI) for staging of breast cancer: the pro CEM perspective[J/OL]. Eur J Radiol, 2021, 142: 109883 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/34358810/. DOI: 10.1016/j.ejrad.2021.109883.
[16]
FAERMANN R, SPERBER F, SCHNEEBAUM S, et al. Tumor-to-breast volume ratio as measured on MRI: a possible predictor of breast-conserving surgery versus mastectomy[J]. Isr Med Assoc J, 2014, 16(2): 101-105.
[17]
STREETER S S, ZUURBIER R A, DIFLORIO-ALEXANDER R M, et al. Breast-conserving surgery margin guidance using micro-computed tomography: challenges when imaging radiodense resection specimens[J]. Ann Surg Oncol, 2023, 30(7): 4097-4108. DOI: 10.1245/s10434-023-13364-z.
[18]
WEAVER O, YANG W. Imaging of breast cancers with predilection for nonmass pattern of growth: invasive lobular carcinoma and DCIS-does imaging capture it all?[J]. AJR Am J Roentgenol, 2020, 215(6): 1504-1511. DOI: 10.2214/AJR.19.22027.
[19]
COZZI A, DI LEO G, HOUSSAMI N, et al. Screening and diagnostic breast MRI: how do they impact surgical treatment? Insights from the MIPA study[J]. Eur Radiol, 2023, 33(9): 6213-6225. DOI: 10.1007/s00330-023-09600-5.
[20]
GOTO M, NAKANO S, SAITO M, et al. Evaluation of an MRI/US fusion technique for the detection of non-mass enhancement of breast lesions detected by MRI yet occult on conventional B-mode second-look US[J]. J Med Ultrason, 2022, 49(2): 269-278. DOI: 10.1007/s10396-021-01175-2.
[21]
JAFFERBHOY S F, GOUSSOUS G, CHANDARANA M, et al. Impact of preoperative MRI in invasive ductal carcinoma with lobular features on core biopsy[J/OL]. Clin Breast Cancer, 2021, 21(3): e194-e198 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/33279405/. DOI: 10.1016/j.clbc.2020.08.007.
[22]
SELVI V, NORI J, MEATTINI I, et al. Role of magnetic resonance imaging in the preoperative staging and work-up of patients affected by invasive lobular carcinoma or invasive ductolobular carcinoma[J/OL]. Biomed Res Int, 2018, 2018: 1569060 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/30046588/. DOI: 10.1155/2018/1569060.
[23]
MANN R M. The effectiveness of MR imaging in the assessment of invasive lobular carcinoma of the breast[J]. Magn Reson Imaging Clin N Am, 2010, 18(2): 259-276. DOI: 10.1016/j.mric.2010.02.005.
[24]
KUTOMI G, SHIMA H, KYUNO D, et al. Positional advantages of supine MRI for diagnosis prior to breast-conserving surgery[J/OL]. Mol Clin Oncol, 2023, 18(5): 44 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/37090744/. DOI: 10.3892/mco.2023.2640.
[25]
LIU J J, ZHOU D D, PAN T, et al. Socioeconomic and clinical factors affecting the proportion of breast conserving surgery in Chinese women with breast cancer[J]. Gland Surg, 2022, 11(2): 341-351. DOI: 10.21037/gs-22-25.
[26]
BAE M S, BERNARD-DAVILA B, SUNG J S, et al. Preoperative breast MRI features associated with positive or close margins in breast-conserving surgery[J/OL]. Eur J Radiol, 2019, 117: 171-177 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/31307644/. DOI: 10.1016/j.ejrad.2019.06.011.
[27]
BAHL M, BAKER J A, KINSEY E N, et al. MRI predictors of tumor-positive margins after breast-conserving surgery[J/OL]. Clin Imaging, 2019, 57: 45-49 [2023-07-12]. https://pubmed.ncbi.nlm.nih.gov/31128385/. DOI: 10.1016/j.clinimag.2019.05.006.
[28]
KIM O H, KIM S J, LEE J S. Enhancing patterns of breast cancer on preoperative dynamic contrast-enhanced magnetic resonance imaging and resection margin in breast conserving therapy[J]. Breast Dis, 2016, 36(1): 27-35. DOI: 10.3233/BD-150195.
[29]
KOH J, PARK A Y, KO K H, et al. Can enhancement types on preoperative MRI reflect prognostic factors and surgical outcomes in invasive breast cancer?[J]. Eur Radiol, 2019, 29(12): 7000-7008. DOI: 10.1007/s00330-019-06236-2.
[30]
LI X S, SONG Y L, LI D C, et al. Preoperative dynamic contrast-enhanced MRI can reduce the rate of tumor-positive resection margins after breast conserving surgery in patients with early non-mass breast carcinoma[J]. Chin J Oncol, 2017, 39(10): 768-774. DOI: 10.3760/cma.j.issn.0253-3766.2017.10.010.
[31]
OBDEIJN I M, TILANUS-LINTHORST M M, SPRONK S, et al. Preoperative breast MRI can reduce the rate of tumor-positive resection margins and reoperations in patients undergoing breast-conserving surgery[J]. AJR Am J Roentgenol, 2013, 200(2): 304-310. DOI: 10.2214/AJR.12.9185.
[32]
FANCELLU A, SORO D, CASTIGLIA P, et al. Usefulness of magnetic resonance in patients with invasive cancer eligible for breast conservation: a comparative study[J]. Clin Breast Cancer, 2014, 14(2): 114-121. DOI: 10.1016/j.clbc.2013.10.002.
[33]
JUNG J J, KANG E, KIM E K, et al. External validation and modification of nomogram for predicting positive resection margins before breast conserving surgery[J]. Breast Cancer Res Treat, 2020, 183(2): 373-380. DOI: 10.1007/s10549-020-05779-z.
[34]
YOON J, KIM E K, KIM M J, et al. Preoperative magnetic resonance imaging features associated with positive resection margins in patients with invasive lobular carcinoma[J]. Korean J Radiol, 2020, 21(8): 946-954. DOI: 10.3348/kjr.2019.0674.
[35]
KANG J H, YOUK J H, KIM J A, et al. Identification of preoperative magnetic resonance imaging features associated with positive resection margins in breast cancer: a retrospective study[J]. Korean J Radiol, 2018, 19(5): 897-904. DOI: 10.3348/kjr.2018.19.5.897.
[36]
LIAO G J, HENZE BANCROFT L C, STRIGEL R M, et al. Background parenchymal enhancement on breast MRI: a comprehensive review[J]. J Magn Reson Imaging, 2020, 51(1): 43-61. DOI: 10.1002/jmri.26762.
[37]
NGUYEN A A, ARASU V A, STRAND F, et al. Comparison of segmentation methods in assessing background parenchymal enhancement as a biomarker for response to neoadjuvant therapy[J]. Tomography, 2020, 6(2): 101-110. DOI: 10.18383/j.tom.2020.00009.
[38]
RELLA R, BUFI E, BELLI P, et al. Association between background parenchymal enhancement and tumor response in patients with breast cancer receiving neoadjuvant chemotherapy[J]. Diagn Interv Imaging, 2020, 101(10): 649-655. DOI: 10.1016/j.diii.2020.05.010.
[39]
GRIMM L J, SAHA A, GHATE S V, et al. Relationship between background parenchymal enhancement on high-risk screening MRI and future breast cancer risk[J]. Acad Radiol, 2019, 26(1): 69-75. DOI: 10.1016/j.acra.2018.03.013.
[40]
HOUSSAMI N, TURNER R, MORROW M. Preoperative magnetic resonance imaging in breast cancer: meta-analysis of surgical outcomes[J]. Ann Surg, 2013, 257(2): 249-255. DOI: 10.1097/SLA.0b013e31827a8d17.

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