Abstract
BackgroundTo investigate if baseline and/or changes in contralateral background parenchymal enhancement (BPE) and fibroglandular tissue (FGT) measured on magnetic resonance imaging (MRI) and mammographic breast density (MD) can be used as imaging biomarkers for overall and recurrence-free survival in patients with invasive lobular carcinomas (ILCs) undergoing adjuvant endocrine treatment.MethodsWomen who fulfilled the following inclusion criteria were included in this retrospective HIPAA-compliant IRB-approved study: unilateral ILC, pre-treatment breast MRI and/or mammography from 2000 to 2010, adjuvant endocrine treatment, follow-up MRI, and/or mammography 1–2 years after treatment onset. BPE, FGT, and mammographic MD of the contralateral breast were independently graded by four dedicated breast radiologists according to BI-RADS. Associations between the baseline levels and change in levels of BPE, FGT, and MD with overall survival and recurrence-free survival were assessed using Kaplan–Meier survival curves and Cox regression analysis.ResultsTwo hundred ninety-eight patients (average age = 54.1 years, range = 31–79) fulfilled the inclusion criteria. The average follow-up duration was 11.8 years (range = 2–19). Baseline and change in levels of BPE, FGT, and MD were not significantly associated with recurrence-free or overall survival. Recurrence-free and overall survival were affected by histological subtype (p < 0.0001), number of metastatic axillary lymph nodes (p < 0.0001), age (p = 0.01), and adjuvant endocrine treatment duration (p < 0.001).ConclusionsQualitative evaluation of BPE, FGT, and mammographic MD changes cannot predict which patients are more likely to benefit from adjuvant endocrine treatment.
Highlights
To investigate if baseline and/or changes in contralateral background parenchymal enhancement (BPE) and fibroglandular tissue (FGT) measured on magnetic resonance imaging (MRI) and mammographic breast density (MD) can be used as imaging biomarkers for overall and recurrence-free survival in patients with invasive lobular carcinomas (ILCs) undergoing adjuvant endocrine treatment
Qualitative evaluation of BPE, FGT, and mammographic MD changes cannot predict which patients are more likely to benefit from adjuvant endocrine treatment
The purpose of our study was to investigate if baseline and/or changes in contralateral BPE and FGT on MRI and mammographic MD after adjuvant endocrine therapy can be used as imaging biomarkers for overall and recurrencefree survival in patients with ILC
Summary
To investigate if baseline and/or changes in contralateral background parenchymal enhancement (BPE) and fibroglandular tissue (FGT) measured on magnetic resonance imaging (MRI) and mammographic breast density (MD) can be used as imaging biomarkers for overall and recurrence-free survival in patients with invasive lobular carcinomas (ILCs) undergoing adjuvant endocrine treatment. Invasive lobular carcinomas (ILCs) constitute approximately 10% of breast cancers [1] and have similar or worse outcomes compared with stage-matched invasive ductal carcinomas (IDC) [2, 3] even though they often present with good prognostic features (low-grade estrogen- and progesterone-positive tumors and negative HER2 protein amplification). They possess a different histologic and genetic makeup from IDCs, presenting with small noncohesive cells that grow in a linear fashion and infiltrate the stroma. Those studies have focused on only ductal breast cancers (invasive and in situ) or on both ductal and lobular as a single entity (with the latter being less commonly represented across the studies)
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