Abstract
PurposeTo investigate associations between the clinicopathologic features and MRI features of triple-negative breast cancer (TNBC) and ER-positive breast cancer (BC) via apparent diffusion coefficient (ADC) histogram analysis.Materials and methodsIn this study, 221 breast cancer patients with pre-operative MRI performed from August 2009 to March 2015 were included in a retrospective analysis. All patients had a pathologically confirmed diagnosis of invasive carcinoma and were grouped into ER-positive (149) or triple-negative (72) subtypes. DWI rim sign and various ADC parameters (mean; mode; 25, 50, and 75 percentiles; skewness; and kurtosis) between ER-positive and TNBC were compared using whole-lesion ADC histogram analysis. Univariate and multivariate regression analyses were used for statistical comparison.ResultsDWI rim signs were detected in 42.3% and 41.7% of ER-positive subtype and TNBC, respectively (P = 0.931). TNBC had poorer histologic grade (P<0.001) and higher Ki-67 expression (P <0.001) than ER-positive subtype BC. TNBC displayed higher ADC parameters (mean, mode, 50th & 75th percentiles, kurtosis on univariate analysis, all P<0.001; only kurtosis on multivariate anaylsis; P<0.001) than ER-positive subtype BC. TNBC had significantly more recurrence events than ER-positive subtype BC on univarate analysis (9.7% (7/72) vs. 2.7% (4/149), P = 0.035).ConclusionPoorer clinicopathologic outcomes were found in TNBC. Whole-lesion ADC histogram analysis revealed ADC kurtosis to be higher in TNBC than ER-positive subtype BC.
Highlights
Breast cancer is recognized as a group of highly heterogeneous diseases and is further categorized into three major different subtypes based on immunohistochemical expression of receptors: triple-negative [estrogen receptor (ER) negative, progesterone receptor (PR) negative, and human epidermal growth factor receptor 2 (HER2) negative], HER2-positive (HER2+; ER and PR + or -), and ER-positive (ER+, HER2, PR + or -) [1,2]
diffusion-weighted image (DWI) rim signs were detected in 42.3% and 41.7% of ER-positive subtype and triple-negative breast cancer (TNBC), respectively (P = 0.931)
Poorer clinicopathologic outcomes were found in TNBC
Summary
Breast cancer is recognized as a group of highly heterogeneous diseases and is further categorized into three major different subtypes based on immunohistochemical expression of receptors: triple-negative [estrogen receptor (ER) negative, progesterone receptor (PR) negative, and human epidermal growth factor receptor 2 (HER2) negative], HER2-positive (HER2+; ER and PR + or -), and ER-positive (ER+, HER2-, PR + or -) [1,2]. Because of this mixed spectrum of gene expression, each subtype displays different clinical behaviors, responses to treatment, and prognosis. Kim et al found that various ADC histogram parameters correlated with prognostic factors and subtypes of invasive ductal carcinoma (IDC). [11]
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