MRI-only breast cancers are less aggressive than cancers identifiable on conventional imaging

IF 3.2 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

European Journal of Radiology Pub Date : 2024-10-11 DOI:10.1016/j.ejrad.2024.111781

Melis Baykara Ulusan , Francesca Ferrara , Emine Meltem , Paola Clauser , Thomas H. Helbich , Pascal A.T. Baltzer

{"title":"MRI-only breast cancers are less aggressive than cancers identifiable on conventional imaging","authors":"Melis Baykara Ulusan , Francesca Ferrara , Emine Meltem , Paola Clauser , Thomas H. Helbich , Pascal A.T. Baltzer","doi":"10.1016/j.ejrad.2024.111781","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Magnetic resonance imaging (MRI) has a superior sensitivity for the diagnosis of breast cancer, leading to lesions primarily detected by MRI. Some of these lesions cannot be identified by targeted second-look ultrasound (SLUS) examinations and are thus referred to as MRI-only lesions. We hypothesize that biologically more aggressive cancers lead to more distinct tissue damage improving visibility on SLUS.</div></div><div><h3>Objective</h3><div>To investigate whether there are differences in cancer subtypes between MRI-only and SLUS-detected malignant lesions.</div></div><div><h3>Methods</h3><div>This retrospective single-center observational study evaluated 435 patients who received breast MRI examinations between January 2017 and December 2022, with at least one lesion primarily detected on MRI and histologically confirmed as malignant. Demographic characteristics, lesion type (mass or non-mass), MRI-assessed lesion size (mm), histological diagnosis, stage, immunohistochemical analysis (ER, PR, HER-2, Ki-67), and lymph node status were assessed and compared between MRI-only and SLUS-detected.</div></div><div><h3>Results</h3><div>Among 435 patients (mean age of 57.4 ± 13.3), 34.02 % (n = 148) were in the MRI-only group, while the remaining 65.98 % (n = 287) were identified by SLUS. MRI-only cases were significantly smaller in size (10 mm vs 20 mm), mostly staged as T1 (66.9 %) and showed features associated with less biological aggressiveness (higher pure ductal carcinoma in situ rates: 30.4 % vs 5.2 %; lower Ki-67, median values: 10 vs 20) compared to SLUS-detected cases (<em>P</em> < 0.001). SLUS-detected cancers had higher ratios of microscopic (4.9 % vs 3.4 %) and macroscopic axillary metastasis (26.8 % vs 7.4 %) compared to MRI-only lesions (<em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>MRI-only lesions presented histologically and immunohistochemically with less aggressive patterns compared to those detected via SLUS.</div><div>Clinic Impact: Our data provide evidence that MRI-only lesions are biologically less aggressive and of lower stage, offering the potential of earlier treatment chance since they are visible on MRI before becoming more aggressive and destructive.</div></div>","PeriodicalId":12063,"journal":{"name":"European Journal of Radiology","volume":"181 ","pages":"Article 111781"},"PeriodicalIF":3.2000,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Radiology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0720048X24004972","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Magnetic resonance imaging (MRI) has a superior sensitivity for the diagnosis of breast cancer, leading to lesions primarily detected by MRI. Some of these lesions cannot be identified by targeted second-look ultrasound (SLUS) examinations and are thus referred to as MRI-only lesions. We hypothesize that biologically more aggressive cancers lead to more distinct tissue damage improving visibility on SLUS.

Objective

To investigate whether there are differences in cancer subtypes between MRI-only and SLUS-detected malignant lesions.

Methods

This retrospective single-center observational study evaluated 435 patients who received breast MRI examinations between January 2017 and December 2022, with at least one lesion primarily detected on MRI and histologically confirmed as malignant. Demographic characteristics, lesion type (mass or non-mass), MRI-assessed lesion size (mm), histological diagnosis, stage, immunohistochemical analysis (ER, PR, HER-2, Ki-67), and lymph node status were assessed and compared between MRI-only and SLUS-detected.

Results

Among 435 patients (mean age of 57.4 ± 13.3), 34.02 % (n = 148) were in the MRI-only group, while the remaining 65.98 % (n = 287) were identified by SLUS. MRI-only cases were significantly smaller in size (10 mm vs 20 mm), mostly staged as T1 (66.9 %) and showed features associated with less biological aggressiveness (higher pure ductal carcinoma in situ rates: 30.4 % vs 5.2 %; lower Ki-67, median values: 10 vs 20) compared to SLUS-detected cases (P < 0.001). SLUS-detected cancers had higher ratios of microscopic (4.9 % vs 3.4 %) and macroscopic axillary metastasis (26.8 % vs 7.4 %) compared to MRI-only lesions (P < 0.001).

Conclusion

MRI-only lesions presented histologically and immunohistochemically with less aggressive patterns compared to those detected via SLUS.

Clinic Impact: Our data provide evidence that MRI-only lesions are biologically less aggressive and of lower stage, offering the potential of earlier treatment chance since they are visible on MRI before becoming more aggressive and destructive.

Abstract Image

查看原文本刊更多论文

纯磁共振成像乳腺癌的侵袭性低于传统成像可识别的癌症。

背景：磁共振成像（MRI）在诊断乳腺癌方面具有更高的灵敏度，因此主要通过磁共振成像检测病灶。其中一些病灶无法通过有针对性的二维超声波（SLUS）检查确定，因此被称为仅磁共振成像病灶。我们假设，生物侵袭性更强的癌症会导致更明显的组织损伤，从而提高 SLUS 的可见度：研究仅 MRI 检测到的恶性病变与 SLUS 检测到的恶性病变在癌症亚型上是否存在差异：这项回顾性单中心观察研究评估了2017年1月至2022年12月期间接受乳腺MRI检查的435例患者，这些患者至少有一个病变主要是在MRI上检测到的，并经组织学证实为恶性病变。研究人员对患者的人口统计学特征、病灶类型（肿块或非肿块）、MRI评估的病灶大小（毫米）、组织学诊断、分期、免疫组化分析（ER、PR、HER-2、Ki-67）和淋巴结状态进行了评估，并对纯MRI检测和SLUS检测的病灶进行了比较：在435名患者（平均年龄为57.4 ± 13.3）中，仅磁共振成像组占34.02%（n = 148），其余65.98%（n = 287）通过SLUS检测。仅使用核磁共振成像的病例体积明显较小（10 毫米对 20 毫米），大部分分期为 T1（66.9%），并显示出与生物侵袭性较低相关的特征（纯导管原位癌率较高：30.4% 对 5.2%）：30.4%对5.2%；Ki-67较低，中位值为10对20）：与SLUS检测到的病例相比（P与 SLUS 检测到的病例相比，仅通过 MRI 检测到的病变在组织学和免疫组化方面的侵袭性较低。临床影响：我们的数据提供了证据，证明只在核磁共振成像上显示的病变在生物学上侵袭性较低且分期较低，这为早期治疗提供了机会，因为这些病变在变得更具侵袭性和破坏性之前就能在核磁共振成像上显示出来。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

European Journal of Radiology 医学-核医学

CiteScore

6.70

自引率

3.00%

发文量

398

审稿时长

42 days

期刊介绍： European Journal of Radiology is an international journal which aims to communicate to its readers, state-of-the-art information on imaging developments in the form of high quality original research articles and timely reviews on current developments in the field. Its audience includes clinicians at all levels of training including radiology trainees, newly qualified imaging specialists and the experienced radiologist. Its aim is to inform efficient, appropriate and evidence-based imaging practice to the benefit of patients worldwide.