Radiologic-Pathologic Correlation of Nonmass Enhancement Contiguous with Malignant Index Breast Cancer Masses at Preoperative Breast MRI.

IF 5.6 Q1 ONCOLOGY Radiology. Imaging cancer Pub Date : 2024-03-01 DOI:10.1148/rycan.230060
Derek L Nguyen, Mira Lotfalla, Ashley Cimino-Mathews, Mehran Habibi, Emily B Ambinder
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Abstract

Purpose To determine the pathologic features of nonmass enhancement (NME) directly adjacent to biopsy-proven malignant masses (index masses) at preoperative MRI and determine imaging characteristics that are associated with a malignant pathologic condition. Materials and Methods This retrospective study involved the review of breast MRI and mammography examinations performed for evaluating disease extent in patients newly diagnosed with breast cancer from July 1, 2016, to September 30, 2019. Inclusion criteria were limited to patients with an index mass and the presence of NME extending directly from the mass margins. Wilcoxon rank sum test, Fisher exact test, and χ2 test were used to analyze cancer, patient, and imaging characteristics associated with the NME diagnosis. Results Fifty-eight patients (mean age, 58 years ± 12 [SD]; all women) were included. Malignant pathologic findings for mass-associated NME occurred in 64% (37 of 58) of patients, 43% (16 of 37) with ductal carcinoma in situ and 57% (21 of 37) with invasive carcinoma. NME was more likely to be malignant when associated with an index cancer that had a low Ki-67 index (<20%) (P = .04). The presence of calcifications at mammography correlating with mass-associated NME was not significantly associated with malignant pathologic conditions (P = .19). The span of suspicious enhancement measured at MRI overestimated the true span of disease at histologic evaluation (P < .001), while there was no evidence of a difference between span of calcifications at mammography and true span of disease at histologic evaluation (P = .27). Conclusion Mass-associated NME at preoperative MRI was malignant in most patients with newly diagnosed breast cancer. The span of suspicious enhancement measured at MRI overestimated the true span of disease found at histologic evaluation. Keywords: Breast, Mammography © RSNA, 2024 See also the commentary by Newell in this issue.

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术前乳腺磁共振成像中与恶性指数乳腺癌肿块毗连的非肿块增强的放射学与病理学相关性。
目的 确定术前 MRI 检查中与活检证实的恶性肿块(指标肿块)直接相邻的非肿块增强(NME)的病理特征,并确定与恶性病理状况相关的成像特征。材料与方法 该回顾性研究回顾了 2016 年 7 月 1 日至 2019 年 9 月 30 日期间为评估新诊断为乳腺癌患者的疾病范围而进行的乳腺 MRI 和乳腺 X 光检查。纳入标准仅限于有指数肿块且存在直接从肿块边缘延伸的 NME 的患者。采用Wilcoxon秩和检验、Fisher精确检验和χ2检验分析与NME诊断相关的癌症、患者和影像学特征。结果 共纳入 58 例患者(平均年龄 58 岁 ± 12 [SD];均为女性)。64%的患者(58 例中有 37 例)出现肿块相关 NME 的恶性病理结果,其中 43%(37 例中有 16 例)为导管原位癌,57%(37 例中有 21 例)为浸润癌。当指标癌的Ki-67指数较低时,NME更有可能是恶性的(P = .04)。乳腺放射摄影中出现的钙化与肿块相关的NME与恶性病理情况无明显关联(P = .19)。核磁共振成像测量的可疑强化跨度高估了组织学评估的真实病变跨度(P < .001),而乳腺X光检查的钙化跨度与组织学评估的真实病变跨度之间没有差异(P = .27)。结论 大多数新诊断的乳腺癌患者术前磁共振成像中与肿块相关的 NME 是恶性的。磁共振成像测得的可疑强化跨度高估了组织学评估时发现的真实疾病跨度。关键词乳腺、乳腺放射摄影 © RSNA, 2024 另请参阅本期 Newell 的评论。
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