The association between MRI findings and breast cancer subtypes: focused on the combination patterns on diffusion-weighted and T2-weighted images.

Abstract

PURPOSE:

To assess morphology on diffusion-weighted imaging (DWI) and intratumoral signal intensity (SI) on T2-weighted images (T2WI) of breast carcinomas, and to evaluate the association between the combined DWI and T2WI findings and breast cancer subtypes.

METHODS:

Two hundred and eighty breast cancer patients who underwent breast MRI prior to therapy were included in this retrospective study. All had invasive carcinomas, which were classified into five subtypes: Luminal A-like (n = 149), Luminal B-like (n = 63), Hormone receptor-positive HER2 (n = 31), Hormone receptor-negative HER2 (n = 13), or Triple-negative (TN) (n = 24). Based on the morphology on DWI, the tumors were classified into two patterns: DWI-homogeneous or DWI-heterogeneous. If DWI-heterogeneous, an assessment of intratumoral SI on T2WI was performed: tumors with intratumoral high/low SI on T2WI were classified as Hete-H/Hete-L, respectively. The associations between (1) the morphological patterns on DWI and the five subtypes, and (2) the intratumoral SI patterns on T2WI and the five subtypes in DWI-heterogeneous were evaluated.

RESULTS:

There was a significant association between (1) the morphological patterns on DWI and the five subtypes (p < 0.0001), and (2) the intratumoral SI patterns on T2WI and the five subtypes in DWI-heterogeneous (p < 0.0001). DWI-homogeneous was dominant in Luminal A-like (67.1%), and Hete-H was dominant in TN type (75%). Hete-H, suggesting the presence of intratumoral necrosis, included high proliferative and/or aggressive subtypes more frequently (80%) than Hete-L, suggesting the presence of fibrotic focus. Fibrotic focus was seen more commonly in the luminal subtypes.

CONCLUSION:

The combined findings on DWI and T2WI revealed breast carcinomas that were associated with particular subtypes.

• Authors: Sachiko Yuen, Shuichi Monzawa, Seiji Yanai, Hajime Matsumoto, Yoshihiro Yata, You Ichinose, Teruyuki Deai, Takashi Hashimoto, Takashi Tashiro, Kazuhiko Yamagami
• Journal: Breast cancer (Tokyo, Japan) (Breast Cancer) Vol. 27 Issue 5 Pg. 1029-1037 (Sep 2020) ISSN: 1880-4233 [Electronic] Japan
• PMID: 32377938 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• Receptors, Estrogen
• Receptors, Progesterone
• ERBB2 protein, human
• Receptor, ErbB-2

Topics

• Adult
• Aged
• Breast (diagnostic imaging, pathology, surgery)
• Breast Neoplasms (diagnosis, pathology, therapy)
• Carcinoma, Ductal, Breast (diagnosis, pathology)
• Chemotherapy, Adjuvant
• Contrast Media (administration & dosage)
• Diffusion Magnetic Resonance Imaging
• Female
• Humans
• Mastectomy
• Middle Aged
• Neoadjuvant Therapy
• Receptor, ErbB-2 (metabolism)
• Receptors, Estrogen (metabolism)
• Receptors, Progesterone (metabolism)
• Retrospective Studies