Abstract
There has been a major need to better understand the biological characteristics of triple-negative breast cancers. Compared with estrogen receptor (ER)-positive cancers, several magnetic resonance (MR) imaging findings have been reported as characteristic findings. However, information regarding their location has not been described. Our study was to compare the location of triple-negative breast cancers with that of ER-positive breast cancers using magnetic resonance (MR) imaging. The locations of 1102 primary breast cancers (256 triple-negative and 846 ER-positive) in 1090 women (mean, 52.1 years) were reviewed using three-dimensional (3D) coordinates. The x-axis measurement was recorded as the transverse distance from the posterior nipple line; y-axis measurement as the anteroposterior distance from the chest wall; z-axis measurement as the superoinferior distance from the posterior nipple line. The association between breast cancer subtype and tumor location was evaluated using multiple linear regression analysis. Triple-negative breast cancers were significantly closer to the chest wall than ER-positive breast cancers in absolute (1.8 cm vs. 2.3 cm, P < .0001) and normalized (0.21 vs. 0.25, P < .0001) y-axis distances. The x- and z-axes distances were not significantly different between triple-negative and ER-positive breast cancers. Multiple linear regression analysis revealed that age, mammographic density, axillary nodal status, and triple-negative subtype were significantly associated with absolute and normalized distances from the chest wall (all P < .05). Our results show that triple-negative breast cancers have a tendency toward a posterior or prepectoral location compared with ER-positive breast cancers.
Highlights
Previous studies have shown that the location of a primary cancer could affect tumor growth patterns and have a prognostic significance [1]
Triple-negative breast cancers have been reported to have less axillary lymph node metastasis but poorer prognosis due to distant metastasis compared with estrogen receptor (ER)-positive cancers [11, 13]
Among 1102 breast cancers, we found no significant differences in the distribution of quadrants and mediolateral locations between triple-negative and ER-positive breast cancers (Table 2)
Summary
Previous studies have shown that the location of a primary cancer could affect tumor growth patterns and have a prognostic significance [1]. One such study reported that patients with tumors in the medial location of the breast have worse prognosis [2, 3], and occult spread to PLOS ONE | DOI:10.1371/journal.pone.0116344. Location of Triple-Negative Breast Cancers on MR Imaging internal mammary lymph nodes was attributed to an increased risk of relapse and breast cancer death for patients with tumors in the medial location of the breast. Research has demonstrated that lymph node metastasis occurs more commonly in tumors located in the lateral portion of the breast [4, 5]. In addition to their prognostic significance, familial breast cancers have been reported to have a preferential location. A posterior or prepectoral tumor location has been regarded as a reason for missed cancers on mammography, when combined with dense parenchyma [7,8,9]
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