The Predictive Role of Mammography, Dynamic Contrast-Enhanced Breast Magnetic Resonance Imaging and Diffusion-Weighted Imaging in Hormone Receptor Status of Pure Ductal Carcinoma In Situ Lesions.

Almıla Coşkun Bilge, Zarife Melda Bulut
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Abstract

Objective: The aim of this retrospective study was to analyze the predictive capabilities of preoperative mammography, dynamic contrast-enhanced-magnetic resonance imaging (DCE-MRI), and diffusion-weighted imaging (DWI) in determining hormone receptor (HRc) status for pure ductal carcinoma in situ (DCIS) lesions.

Materials and methods: The study included a total of 79 patients who underwent preoperative mammography (MG) and MRI between December 2018 and December 2023 and were subsequently diagnosed with pure DCIS after surgery. The correlation between MG, DCE-MRI, and DWI features and estrogen receptor (ER) and progesterone receptor (PR) status was examined.

Results: Among the lesions, 44 were double HRc-positive (ER and PR-positive), 13 were single HRc-positive (ER-positive and PR-negative or ER-negative and PR-positive) and 22 were double HRc-negative (ER and PR-negative). The presence of symptom (p = 0.029), the presence of comedo necrosis (p = 0.005) and high histological grade (p<0.001) were found to be associated with ER and PR negativity. Amorphous microcalcifications were more commonly observed in the double HRc-negative group, while linear calcifications were more prevalent in both double and single HRc-positive groups (p = 0.020). Non-mass enhancement (NME) with a linear distribution was significantly more common in double HRc-negative lesions (38%), and NME with a segmental distribution in both double (43%) and single (50%) receptor-positive lesions (p = 0.042). Evaluation of DWI findings revealed that a higher lesion-to-normal breast parenchyma apparent diffusion coefficient (ADC) ratio statistically increased the probability of HRc positivity (p = 0.033).

Conclusion: Certain clinicopathological, mammography, and MRI features, along with the lesion-to-normal breast parenchyma ADC ratio, can serve as predictors for HRc status in DCIS lesions.

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乳腺放射摄影、动态对比增强乳腺磁共振成像和弥散加权成像对纯原位乳管癌病变的激素受体状态的预测作用。
研究目的这项回顾性研究旨在分析术前乳腺放射摄影、动态对比增强磁共振成像(DCE-MRI)和弥散加权成像(DWI)在确定纯导管原位癌(DCIS)病变的激素受体(HRc)状态方面的预测能力:研究纳入了2018年12月至2023年12月期间接受术前乳腺X线摄影(MG)和MRI检查、术后确诊为纯DCIS的共79例患者。研究人员考察了MG、DCE-MRI和DWI特征与雌激素受体(ER)和孕激素受体(PR)状态之间的相关性:病变中,44 例为双 HRc 阳性(ER 和 PR 阳性),13 例为单 HRc 阳性(ER 阳性和 PR 阴性或 ER 阴性和 PR 阳性),22 例为双 HRc 阴性(ER 和 PR 阴性)。存在症状(p = 0.029)、合并坏死(p = 0.005)和组织学分级高(pp = 0.020)。线性分布的非肿块强化(NME)在双 HRc 阴性病变中明显更常见(38%),而节段分布的非肿块强化在双受体阳性病变(43%)和单受体阳性病变(50%)中都更常见(p = 0.042)。对 DWI 结果的评估显示,病变与正常乳腺实质的表观弥散系数(ADC)比值越高,HRc 阳性的概率就越高(p = 0.033):结论:某些临床病理学、乳腺 X 线照相术和 MRI 特征以及病变与正常乳腺实质的 ADC 比值可作为 DCIS 病变 HRc 状态的预测指标。
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