The value of dynamic contrast-enhanced MRI in differentiating triple-negative breast cancer from other subtypes

Heba Azzam,Lamiaa I A Metwally,Hany El-Assaly,Rasha Kamal

doi:10.1186/s43055-019-0118-4

Heba Azzam, Lamiaa I A Metwally + Show 2 more

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https://doi.org/10.1186/s43055-019-0118-4

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Abstract

BackgroundBreast cancer is a broad spectrum disease, including tumors showing different clinical, pathologic, molecular, and imaging features. Triple-negative breast cancer (TNBC) has an extra aggressive clinical course and poor prognosis being considered a diagnostic challenge to breast radiologists, yet it presented quite a lot of predictors on DCE-MRI; these could be valuable in identifying TNBC from other breast cancer subtypes.In this study, we aimed at assessing the DCE-MRI features of triple-negative breast cancer in comparison to other subtypes of breast cancer.ResultsThere was a significant difference between both groups regarding the internal enhancement pattern of mass lesions (P value 0.001), as well as intratumoral bright signal intensity on T2-weighted images (P value < 0.001). However, most of the breast cancer subtypes in this study showed malignant pattern kinetic curves type II and III showing no significant difference (P value 0.673).ConclusionTNBC presented several features with significant differences from other breast cancer molecular subtypes on DCE-MRI including the shape of the lesion and pattern of enhancement as well as high T2 signal intensity, thus improving the diagnosis of TNBC.

Highlights

Breast cancer is a broad spectrum disease, including tumors showing different clinical, pathologic, molecular, and imaging features
No significant difference was presented between both groups
Histopathological diagnosis After revision of core biopsy reports, we found that Triple-negative breast cancer (TNBC) 80/100 (80%) cases were invasive ductal carcinoma, 16/100 (16%) cases were lobular carcinoma, and 4/ 100 (4%) cases were mucoid carcinoma, while in the control group, 84/100 (84%) cases were Invasive ductal carcinoma (IDC), 12/100 (12%) cases were lobular carcinoma, and 4/100 (4%) cases were mixed invasive and lobular carcinoma

Summary

Introduction

Breast cancer is a broad spectrum disease, including tumors showing different clinical, pathologic, molecular, and imaging features. Triple-negative breast cancer (TNBC) has an extra aggressive clinical course and poor prognosis being considered a diagnostic challenge to breast radiologists, yet it presented quite a lot of predictors on DCE-MRI; these could be valuable in identifying TNBC from other breast cancer subtypes. Based on DNA microarray techniques, gene expression profiling of breast cancer has classified breast cancer into five different molecular subtypes having recognized clinical, biologic, and therapeutic effects based on estrogen receptor (ER), progesterone receptor (PR), and HER-2 analysis, which are luminal A, luminal B, (HER 2/neu)-overexpressing, normal breast-like tumor or unclassified group, and basal-like [2–6]. Triple-negative breast cancer (TNBC) has an extra aggressive clinical course and poor prognosis. They have an increased rate of local recurrence and metastatic disease, with a 5-year survival of more or less 75% [8, 9]. The frequency of TNBC is high in younger, habitually premenopausal women [1, 10]

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