Role of contrast-enhanced breast magnetic resonance angiography in characterizing suspicious breast lesions and evaluating the relationship between prognostic factors

Abstract

Aim: Breast cancer is the most commonly diagnosed cancer in women, and mammography and ultrasonography are the most frequently used diagnostic radiological methods. Although they are highly sensitive, their specificity is low. Angiography can be added as a standard breast magnetic resonance imaging (MRI) protocol to increase specificity. In this study, we aimed to investigate the effectiveness of breast vascularity by evaluating the presence of an adjacent vessel sign (AVS) and increased ipsilateral breast vascularity (IIBV) in characterizing breast masses. Methods: 135 patients with a mean age of 47 years with radiologically or clinically suspicious breast masses underwent breast MRI before biopsy. The contrast-enhanced three-dimensional MR angiograms of the breasts were investigated for the presence of AVS and IIBV to characterize suspicious breast masses, and their correlation with histopathological prognostic factors were evaluated. Results: Patients’ age, tumor size, and the presence of AVS and IIBV were significantly higher in malignant masses than in benign masses (P<0.001). The sensitivity, specificity, and accuracy of AVS and IIBV in predicting malignant masses from benign ones were 75%, 79.3%, 77% and 56.9%, 90.4% and 72.5%, respectively. In malignant masses, AVS and IIBV were both significantly associated with ER (P=0.005, P<0.001) and PR expression (P=0.003, P<0.001). We found no relationship between AVS, IIBV and C-ERBB2 expression (P=0.245 and P=0.085, respectively).Conclusion: The presence of AVS and IIBV as determined from contrast-enhanced 3D MR angiograms may be reliable parameters for further characterizing suspicious breast masses, both of which seem to be related with ER and PR expression.