Keywords:
Breast, Oncology, MR, Diagnostic procedure, Cancer
Authors:
H. AYDIN, B. GUNER, I. ESEN BOSTANCI, M. BOYACIOGLU BULUT, B. K. Arıbaş, L. DOGAN, M. A. GULCELİK, O. Unal; Ankara/TR
DOI:
10.1594/ecr2018/C-1238
Methods and materials
The study was designed as a prospective study of invasive ductal breast cancer patients who had been treated at Ankara Oncology Training and Research Hospital between 2015 and 2016.
Ethical approval was obtained from the local ethics committee.
Additional approval was obtained from the hospital board as our institution is considered as a reference hospital for breast cancer.
The MRI values and dynamic results of patients who had MR indications and had underwent MR imaging which revealed they had BIRADS-4 or BIRADS-5 lesions were recorded.
A total of 98 patients were analyzed,
patients who had metastasized stage-4 disease were diagnosed with true-cut biopsy,
and however,
four of these were excluded due to insufficient tissue material for the identification of all pathological parameters.
A further 3 were excluded because their pathological examination revealed the tumors to be ductal carcinoma in-situ.
And 10 were excluded because of benign pathologic results.
Thus,
a final group of 81 patients were enrolled in the study.
MR imaging and dynamic results were evaluated according to breast imaging and reporting data system (BI-RADS)-MR imaging lexicon by a breast radiologist with at least 5-year experience in breast MRI evaluation.
ROI area was designated between 36-100 mm2 and further calculations were performed automatically by the device.
We divided our cases into three groups in regard to initial enhancement values (<50%,
50-100%,
>100%).
Determination of kinetic curve type was done according to post-initial enhancement data; type 1 is defined by stable increase of enhancement,
type 2 is the formation of a plateau of signal intensity after contrast injection,
type 3 is the stable decrease of enhancement in the post-initial phase.
Tumor type was determined by the WHO classification.
Tumor grading (grade 1,
2,
and 3) was accomplished by the modified Bloom-Richardson protocol.
Lymph node involvement and lymphovascular invasion was assessed.
Standardized protocols were used in the staining of Ki-67,
estrogen and progesterone receptors,
and c-erbb2 (Her2/neu) receptor from the invasive part of the tumor.
Comparisons between groups were made with one-way ANOVA and Kruskal Wallis test.
Pairwise comparisons were made with Dunn’s test.
Analysis of categorical variables were made with Chi-square test.