Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients.

IF 2.2 4区医学 Q3 ONCOLOGY Journal of Breast Cancer Pub Date : 2023-10-01 Epub Date: 2023-08-11 DOI:10.4048/jbc.2023.26.e35

Pamela Sung, Jong Yoon Lee, Jong-Ho Cheun, In Sil Choi, Jin Hyun Park, Jeong Hwan Park, Byoung Hyuck Kim, Sohee Oh, A Jung Chu, Ki-Tae Hwang

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Abstract

Purpose: In this study, we investigated the prognostic implications of focal breast edema on preoperative breast magnetic resonance imaging (MRI) in patients with breast cancer.

Methods: Data of 899 patients with breast cancer at a single institution were retrospectively analyzed. The patients were divided into an edema-positive group (EPG) and an edema-negative group (ENG) based on the presence of peritumoral, prepectoral, or subcutaneous edema. Two radiologists evaluated the presence or absence of focal edema and its subtypes on preoperative breast MRI. Clinicopathologic characteristics and survival outcomes were compared between the two groups and among the three subtypes using Pearson's χ² test, Kaplan-Meier estimator, and Cox proportional hazards model.

Results: There were 399 (44.4%) and 500 (55.6%) patients in the EPG and ENG, respectively. The EPG showed significantly higher rates of axillary lymph node metastasis (55.6% vs. 19.2%, p < 0.001) and lymphovascular invasion (LVI) (57.9% vs. 12.6%, p < 0.001) than the ENG. Patients in the EPG showed significantly worse overall survival (OS) rate (log-rank p < 0.001; hazard ratio [HR], 4.83; 95% confidence interval [CI], 2.56-9.11) and recurrence-free survival rate (log-rank p < 0.001; HR, 3.00; 95% CI, 1.94-4.63) than those in the ENG. After adjusting for other variables, focal breast edema remained a significant factor affecting the OS rate, regardless of the edema type. Specifically, the presence of subcutaneous edema emerged as the strongest predictor for OS with the highest HR (p < 0.001; HR, 9.10; 95% CI, 3.05-27.15).

Conclusion: Focal breast edema on preoperative breast MRI implies a higher possibility of LVI and axillary lymph node metastasis, which can lead to a poor prognosis. A detailed description of focal breast edema, especially subcutaneous edema, on preoperative breast MRI may provide prognostic predictions. More intensive surveillance is required for patients with breast cancer and focal preoperative breast edema.

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乳腺局灶性水肿对乳腺癌患者术前乳腺磁共振成像预后的影响。

目的：在本研究中，我们研究了癌症患者术前乳腺磁共振成像（MRI）中局灶性乳腺水肿对预后的影响。方法：回顾性分析某医疗机构899例癌症患者的临床资料。根据肿瘤周围、外周或皮下水肿的存在，将患者分为水肿阳性组（EPG）和水肿阴性组（ENG）。两名放射科医生在术前乳腺MRI上评估了局灶性水肿的存在与否及其亚型。使用Pearsonχ²检验、Kaplan-Meier估计量和Cox比例风险模型比较两组和三种亚型之间的临床病理特征和生存结果。结果：EPG和ENG患者分别为399例（44.4%）和500例（55.6%）。EPG显示腋窝淋巴结转移率（55.6%对19.2%，p＜0.001）和淋巴血管侵袭率（57.9%对12.6%，p＞0.001）显著高于ENG。EPG患者的总生存率（OS）（log秩p＜0.001；危险比[HR]，4.83；95%置信区间[CI]，2.56-9.11）和无复发生存率（log秩p＜0.001；HR，3.00；95%CI，1.94-4.63）明显低于ENG患者。在调整其他变量后，局灶性乳腺水肿仍然是影响OS发生率的重要因素，而不管水肿类型如何。具体而言，皮下水肿是HR最高的OS的最强预测因素（p<0.001；HR，9.10；95%CI，3.05-27.15）。结论：术前乳腺MRI显示局灶性乳腺水肿意味着LVI和腋窝淋巴结转移的可能性更高，这可能导致预后不良。术前乳腺MRI对局灶性乳腺水肿，尤其是皮下水肿的详细描述可以提供预后预测。对于患有癌症和术前局灶性乳房水肿的患者，需要加强监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Breast Cancer 医学-肿瘤学

CiteScore

3.80

自引率

4.20%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Breast Cancer (abbreviated as ''J Breast Cancer'') is the official journal of the Korean Breast Cancer Society, which is issued quarterly in the last day of March, June, September, and December each year since 1998. All the contents of the Journal is available online at the official journal website (http://ejbc.kr) under open access policy. The journal aims to provide a forum for the academic communication between medical doctors, basic science researchers, and health care professionals to be interested in breast cancer. To get this aim, we publish original investigations, review articles, brief communications including case reports, editorial opinions on the topics of importance to breast cancer, and welcome new research findings and epidemiological studies, especially when they contain a regional data to grab the international reader''s interest. Although the journal is mainly dealing with the issues of breast cancer, rare cases among benign breast diseases or evidence-based scientifically written articles providing useful information for clinical practice can be published as well.