Abstract
ObjectivesTo assess breast cancer receptor status and molecular subtypes by using the CAIPIRINHA-Dixon-TWIST-VIBE and readout-segmented echo-planar diffusion weighted imaging techniques.MethodsA total of 165 breast cancer patients were retrospectively recruited. Patient age, estrogen receptor, progesterone receptor, human epidermal growth factorreceptor-2 (HER-2) status, and the Ki-67 proliferation index were collected for analysis. Quantitative parameters (Ktrans, Ve, Kep), semiquantitative parameters (W-in, W-out, TTP), and apparent diffusion coefficient (ADC) values were compared in relation to breast cancer receptor status and molecular subtypes. Statistical analysis were performed to compare the parameters in the receptor status and molecular subtype groups.Multivariate analysis was performed to explore confounder-adjusted associations, and receiver operating characteristic curve analysis was used to assess the classification performance and calculate thresholds.ResultsYounger age (<49.5 years, odds ratio (OR) =0.95, P=0.004), lower Kep (<0.704,OR=0.14, P=0.044),and higher TTP (>0.629 min, OR=24.65, P=0.011) were independently associated with progesterone receptor positivity. A higher TTP (>0.585 min, OR=28.19, P=0.01) was independently associated with estrogen receptor positivity. Higher Kep (>0.892, OR=11.6, P=0.047), lower TTP (<0.582 min, OR<0.001, P=0.004), and lower ADC (<0.719 ×10-3 mm2/s, OR<0.001, P=0.048) had stronger independent associations with triple-negative breast cancer (TNBC) compared to luminal A, and those parameters could differentiate TNBC from luminal A with the highest AUC of 0.811.ConclusionsKep and TTP were independently associated with hormone receptor status. In addition, the Kep, TTP, and ADC values had stronger independent associations with TNBC than with luminal A and could be used as imaging biomarkers for differentiate TNBC from Luminal A.
Highlights
Breast cancer (BC) is the most common cancer diagnosed in women and has a high mortality [1]
A prospectively enrolled patients in our institution that consisted of 577 consecutive patients who underwent CDT-VIBE DCE-MRI and RS-EPI DWI of the breast between January 2016 and August 2018 was queried for patients who fulfilled the following inclusion criteria: postoperative histopathology confirmed BC with receptor status, no recurrence, no previous treatment, not pregnant, and not breastfeeding
progesterone receptor (PR)-positive patients were younger than PR-negative patients (P
Summary
Breast cancer (BC) is the most common cancer diagnosed in women and has a high mortality [1]. Molecular subtypes of BC, based on genotype variations, are critical in determining treatments and predicting prognosis [2,3,4]. Due to the high cost of full genetic analysis, the immunohistochemical (IHC) surrogate biomarkers, including estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor-2 (HER-2), and the Ki-67proliferation index, are routinely used to define these subtypes, which are major prognostic factors in guiding targeted therapy and predicting tumor response to neoadjuvant chemotherapy (NAC) [5, 6]. The current diagnosis of receptor status together with the Ki-67 proliferation index based on IHC requires tissue specimens obtained by invasive biopsy. The biopsy and surgical specimens may have different receptor statuses and Ki-67 proliferation and these indicators may change during treatment [5]. More defined imaging parameters are needed to delineate these prognostic factors [7]
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