Abstract
IntroductionWe present a fully automated method for deriving quantitative measures of background parenchymal enhancement (BPE) from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and perform a preliminary evaluation of these measures to assess the effect of risk-reducing salpingo-oophorectomy (RRSO) in a cohort of breast cancer susceptibility gene 1/2 (BRCA1/2) mutation carriers.MethodsBreast DCE-MRI data from 50 BRCA1/2 carriers were retrospectively analyzed in compliance with the Health Insurance Portability and Accountability Act and with institutional review board approval. Both the absolute (| |) and relative (%) measures of BPE and fibroglandular tissue (FGT) were computed from the MRI scans acquired before and after RRSO. These pre-RRSO and post-RRSO measures were compared using paired Student’s t test. The area under the curve (AUC) of the receiver operating characteristic (ROC) was used to evaluate the performance of relative changes in the BPE and FGT measures in predicting breast cancer that developed in these women after the RRSO surgery.ResultsFor the 44 women who did not develop breast cancer after RRSO, the absolute volume of BPE and FGT had a significant decrease (P < 0.05) post-RRSO, whereas for the 6 women who developed breast cancer, there were no significant changes in these measures. Higher values in all BPE and FGT measures were also observed post-RRSO for the women who developed breast cancer, compared with women who did not. Relative changes in BPE percentage were most predictive of women who developed breast cancer after RRSO (P < 0.05), whereas combining BPE percentage and |FGT| yielded an AUC of 0.80, higher than BPE percentage (AUC = 0.78) or |FGT| (AUC = 0.66) alone (both P > 0.02).ConclusionsQuantitative measures of BPE and FGT are different before and after RRSO, and their relative changes are associated with prediction of developing breast cancer, potentially indicative of women who are more susceptible to develop breast cancer after RRSO in BRCA1/2 mutation carriers.Electronic supplementary materialThe online version of this article (doi:10.1186/s13058-015-0577-0) contains supplementary material, which is available to authorized users.
Highlights
We present a fully automated method for deriving quantitative measures of background parenchymal enhancement (BPE) from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and perform a preliminary evaluation of these measures to assess the effect of risk-reducing salpingo-oophorectomy (RRSO) in a cohort of breast cancer susceptibility gene 1/2 (BRCA1/2) mutation carriers
Likewise, when using SUB 3, there was a significant decrease of the BPE measures after RRSO; the corresponding ranges of the R%cutoff where this decrease was significant expanded to an overall wider range of 0 % to 80 % for |BPE| as well as from 10 % to 100 % for BPE%
In our study, quantitative measures of BPE and fibroglandular tissue (FGT) were computed with data derived from breast DCE-MRI using a fully automated computerized method, and they were subsequently evaluated for a pilot cohort of BRCA1/2 mutation carriers to assess the effect of RRSO
Summary
We present a fully automated method for deriving quantitative measures of background parenchymal enhancement (BPE) from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and perform a preliminary evaluation of these measures to assess the effect of risk-reducing salpingo-oophorectomy (RRSO) in a cohort of breast cancer susceptibility gene 1/2 (BRCA1/2) mutation carriers. Several risk reduction interventions are currently being used clinically, ranging from the less aggressive, such as lifestyle changes [5] and chemoprevention [6, 7], to those that are more aggressive, such as oophorectomy [8] and prophylactic mastectomy [9]. These interventions are effective in reducing cancer risk [10,11,12], they have substantial side effects. Tamoxifen can induce endometrial cancer [13]; oophorectomy is associated with early menopause symptoms [14]; and prophylactic mastectomy is associated with morbidity and psychosocial effects [15]
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