Preoperative MRI Features Associated With Axillary Nodal Burden and Disease-Free Survival in Patients With Early-Stage Breast Cancer.

IF 4.4 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING Korean Journal of Radiology Pub Date : 2024-09-01 DOI:10.3348/kjr.2024.0196

Junjie Zhang, Zhi Yin, Jianxin Zhang, Ruirui Song, Yanfen Cui, Xiaotang Yang

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引用次数: 0

Abstract

Objective: To investigate the potential association among preoperative breast MRI features, axillary nodal burden (ANB), and disease-free survival (DFS) in patients with early-stage breast cancer.

Materials and methods: We retrospectively reviewed 297 patients with early-stage breast cancer (cT1-2N0M0) who underwent preoperative MRI between December 2016 and December 2018. Based on the number of positive axillary lymph nodes (LNs) determined by postoperative pathology, the patients were divided into high nodal burden (HNB; ≥3 positive LNs) and non-HNB (<3 positive LNs) groups. Univariable and multivariable logistic regression analyses were performed to identify independent risk factors associated with ANB. Predictive efficacy was evaluated using the receiver operating characteristic (ROC) curve and area under the curve (AUC). Univariable and multivariable Cox proportional hazards regression analyses were performed to determine preoperative features associated with DFS.

Results: We included 47 and 250 patients in the HNB and non-HNB groups, respectively. Multivariable logistic regression analysis revealed that multifocality/multicentricity (adjusted odds ratio [OR] = 3.905, 95% confidence interval [CI]: 1.685-9.051, P = 0.001) and peritumoral edema (adjusted OR = 3.734, 95% CI: 1.644-8.479, P = 0.002) were independent risk factors for HNB. Combined peritumoral edema and multifocality/multicentricity achieved an AUC of 0.760 (95% CI: 0.707-0.807) for predicting HNB, with a sensitivity and specificity of 83.0% and 63.2%, respectively. During the median follow-up period of 45 months (range, 5-61 months), 26 cases (8.75%) of breast cancer recurrence were observed. Multivariable Cox proportional hazards regression analysis indicated that younger age (adjusted hazard ratio [HR] = 3.166, 95% CI: 1.200-8.352, P = 0.021), larger tumor size (adjusted HR = 4.370, 95% CI: 1.671-11.428, P = 0.002), and multifocality/multicentricity (adjusted HR = 5.059, 95% CI: 2.166-11.818, P < 0.001) were independently associated with DFS.

Conclusion: Preoperative breast MRI features may be associated with ANB and DFS in patients with early-stage breast cancer.

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与早期乳腺癌患者腋窝结节负担和无病生存率相关的术前磁共振成像特征

摘要研究早期乳腺癌患者术前乳腺 MRI 特征、腋窝结节负担（ANB）和无病生存期（DFS）之间的潜在关联：我们回顾性研究了2016年12月至2018年12月期间接受术前MRI检查的297例早期乳腺癌（cT1-2N0M0）患者。根据术后病理确定的腋窝淋巴结（LNs）阳性数目，将患者分为高结节负担（HNB；≥3 个 LNs 阳性）和非 HNB（结果：高结节负荷组和非高结节负荷组分别有 47 名和 250 名患者。多变量逻辑回归分析显示，多病灶性/多中心性（调整后的几率比[OR] = 3.905，95% 置信区间[CI]：1.685-9.0511.685-9.051，P = 0.001）和瘤周水肿（调整后的比值比 [OR] = 3.734，95% 置信区间 [CI]：1.644-8.479，P = 0.002）是 HNB 的独立危险因素。合并瘤周水肿和多灶性/多中心性后，预测 HNB 的 AUC 为 0.760（95% CI：0.707-0.807），敏感性和特异性分别为 83.0% 和 63.2%。在中位 45 个月（5-61 个月）的随访期间，共观察到 26 例（8.75%）乳腺癌复发。多变量考克斯比例危险回归分析表明，年龄较小（调整后危险比[HR] = 3.166，95% CI：1.200-8.352，P = 0.021）、肿瘤体积较大（调整后HR = 4.370，95% CI：1.671-11.428，P = 0.002）和多灶性/多中心性（调整后HR = 5.059，95% CI：2.166-11.818，P < 0.001）与DFS独立相关：结论：术前乳腺磁共振成像特征可能与早期乳腺癌患者的ANB和DFS有关。

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

Korean Journal of Radiology 医学-核医学

CiteScore

10.60

自引率

12.50%

发文量

141

审稿时长

1.3 months

期刊介绍： The inaugural issue of the Korean J Radiol came out in March 2000. Our journal aims to produce and propagate knowledge on radiologic imaging and related sciences. A unique feature of the articles published in the Journal will be their reflection of global trends in radiology combined with an East-Asian perspective. Geographic differences in disease prevalence will be reflected in the contents of papers, and this will serve to enrich our body of knowledge. World''s outstanding radiologists from many countries are serving as editorial board of our journal.