Magnetic resonance imaging insights from active surveillance of women with ductal carcinoma in situ.

IF 6.5 2区医学 Q1 ONCOLOGY NPJ Breast Cancer Pub Date : 2024-08-04 DOI:10.1038/s41523-024-00677-9

Heather I Greenwood, Cristian K Maldonado Rodas, Rita I Freimanis, Alexa C Glencer, Phoebe N Miller, Rita A Mukhtar, Case Brabham, Christina Yau, Jennifer M Rosenbluth, Gillian L Hirst, Michael J Campbell, Alexander Borowsky, Nola Hylton, Laura J Esserman, Amrita Basu

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Abstract

New approaches are needed to determine which ductal carcinoma in situ (DCIS) is at high risk for progression to invasive ductal carcinoma (IDC). We retrospectively studied DCIS patients who declined surgery (2002-2019), and received endocrine therapy (ET) and breast MRI. Baseline MRI and changes at 3 months and 6 months were analyzed by recursive partitioning to stratify IDC risk. Sixty-two patients (63 DCIS; 1 bilateral) with a mean follow-up of 8.5 years were included. Fifty-one percent remained on active surveillance (AS) without evidence of IDC, with a mean duration of 7.6 years. A decision tree based on MRI features of lesion distinctness and background parenchymal enhancement (BPE) at baseline and change after 3 months of ET stratified patients into low, intermediate, and high risk for progression to IDC. MRI imaging features in patients treated with ET and undergoing AS, may help determine which DCIS lesions are at low versus high risk for IDC.

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磁共振成像对患有导管原位癌的妇女进行积极监控的启示。

需要采用新方法来确定哪些导管原位癌（DCIS）具有发展为浸润性导管癌（IDC）的高风险。我们对拒绝手术（2002-2019 年）、接受内分泌治疗 (ET) 和乳腺 MRI 的 DCIS 患者进行了回顾性研究。通过递归分区法分析基线 MRI 以及 3 个月和 6 个月时的变化，对 IDC 风险进行分层。共纳入 62 例患者（63 例 DCIS；1 例双侧），平均随访 8.5 年。51%的患者仍在接受主动监测（AS），未发现IDC证据，平均持续时间为7.6年。根据基线时病灶清晰度和背景实质增强（BPE）的 MRI 特征以及 ET 3 个月后的变化，建立了一个决策树，将患者分为低、中和高风险IDC。接受 ET 治疗和 AS 患者的磁共振成像特征有助于确定哪些 DCIS 病灶具有 IDC 的低风险和高风险。

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来源期刊

NPJ Breast Cancer Medicine-Pharmacology (medical)

CiteScore

10.10

自引率

1.70%

发文量

122

审稿时长

9 weeks

期刊介绍： npj Breast Cancer publishes original research articles, reviews, brief correspondence, meeting reports, editorial summaries and hypothesis generating observations which could be unexplained or preliminary findings from experiments, novel ideas, or the framing of new questions that need to be solved. Featured topics of the journal include imaging, immunotherapy, molecular classification of disease, mechanism-based therapies largely targeting signal transduction pathways, carcinogenesis including hereditary susceptibility and molecular epidemiology, survivorship issues including long-term toxicities of treatment and secondary neoplasm occurrence, the biophysics of cancer, mechanisms of metastasis and their perturbation, and studies of the tumor microenvironment.