MRI characteristics of breast edema for assessing axillary lymph node burden in early-stage breast cancer: a retrospective bicentric study
Objectives To investigate whether breast edema characteristics at preoperative T2-weighted imaging (T2WI) could help evaluate axillary lymph node (ALN) burden in patients with early-stage breast cancer. Methods This retrospective study included women with clinical T1 and T2 stage breast cancer and p...
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| Veröffentlicht in: | European radiology 2022-12, Vol.32 (12), p.8213-8225 |
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| creator | Xu, Zeyan Ding, Yingying Zhao, Ke Han, Chu Shi, Zhenwei Cui, Yanfen Liu, Chunling Lin, Huan Pan, Xipeng Li, Pinxiong Chen, Minglei Wang, Huihui Deng, Xiaohui Liang, Changhong Xie, Yu Liu, Zaiyi |
| description | Objectives
To investigate whether breast edema characteristics at preoperative T2-weighted imaging (T2WI) could help evaluate axillary lymph node (ALN) burden in patients with early-stage breast cancer.
Methods
This retrospective study included women with clinical T1 and T2 stage breast cancer and preoperative MRI examination in two independent cohorts from May 2014 to December 2020. Low (< 3 LNs+) and high (≥ 3 LNs+) pathological ALN (pALN) burden were recorded as endpoint. Breast edema score (BES) was evaluated at T2WI. Univariable and multivariable analyses were performed by the logistic regression model. The added predictive value of BES was examined utilizing the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
Results
A total of 1092 patients were included in this study. BES was identified as the independent predictor of pALN burden in primary (
n
= 677) and validation (
n
= 415) cohorts. The analysis using MRI-ALN status showed that BES significantly improved the predictive performance of pALN burden (AUC: 0.65 vs 0.71,
p
< 0.001; IDI = 0.045,
p
< 0.001; continuous NRI = 0.159,
p
= 0.050). These results were confirmed in the validation cohort (AUC: 0.64 vs 0.69,
p
= 0.009; IDI = 0.050,
p
< 0.001; continuous NRI = 0.213,
p
= 0.047). Furthermore, BES was positively correlated with biologically invasive clinicopathological factors (
p
< 0.05).
Conclusions
In individuals with early-stage breast cancer, preoperative MRI characteristics of breast edema could be a promising predictor for pALN burden, which may aid in treatment planning.
Key Points
• In this retrospective study of 1092 patients with early-stage breast cancer from two cohorts, the MRI characteristic of breast edema has independent and additive predictive value for assessing axillary lymph node burden
.
• Breast edema characteristics at T2WI positively correlated with biologically invasive clinicopathological factors, which may be useful for preoperative diagnosis and treatment planning for individual patients with breast cancer. |
| doi_str_mv | 10.1007/s00330-022-08896-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2676922597</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2740743429</sourcerecordid><originalsourceid>FETCH-LOGICAL-c441t-d6d05ad66ff25d0e8ca80a0291fc636ca4725f9e04731637955919e8c9e31c0e3</originalsourceid><addsrcrecordid>eNp9kctuFDEQRS0EIiHwAyyQJTZsGsqPbrfZoYhApCAkBGvLY1dPHPVjcLkRk0_gq2OYBBALVrZUp66rfBh7KuClADCvCEApaEDKBvreds31PXYstJKNgF7f_-t-xB4RXQGAFdo8ZEeqNaCFkMfsx4dP5zxc-uxDwZyopEB8Gfgmo6fCMeLk-bBk7omQKM1b7r-ncfR5z8f9tLvk8xKRb9YcceZp5ujzuG-o-C3ehQQ_B8yvuecZS15oh6Gkb7WcAs4lp8CprHH_mD0Y_Ej45PY8YV_O3n4-fd9cfHx3fvrmoglai9LELkLrY9cNg2wjYB98Dx6kFUPoVBe8NrIdLII2SnTK2La1wlbMohIBUJ2wF4fcXV6-rkjFTYkC1p1mXFZysjOdlbK1pqLP_0GvljXPdTonjQajlZa2UvJAhbocZRzcLqep_pAT4H6acgdTrppyv0y569r07DZ63UwYf7fcqamAOgBUS_MW85-3_xN7A5CeoIg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2740743429</pqid></control><display><type>article</type><title>MRI characteristics of breast edema for assessing axillary lymph node burden in early-stage breast cancer: a retrospective bicentric study</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Xu, Zeyan ; Ding, Yingying ; Zhao, Ke ; Han, Chu ; Shi, Zhenwei ; Cui, Yanfen ; Liu, Chunling ; Lin, Huan ; Pan, Xipeng ; Li, Pinxiong ; Chen, Minglei ; Wang, Huihui ; Deng, Xiaohui ; Liang, Changhong ; Xie, Yu ; Liu, Zaiyi</creator><creatorcontrib>Xu, Zeyan ; Ding, Yingying ; Zhao, Ke ; Han, Chu ; Shi, Zhenwei ; Cui, Yanfen ; Liu, Chunling ; Lin, Huan ; Pan, Xipeng ; Li, Pinxiong ; Chen, Minglei ; Wang, Huihui ; Deng, Xiaohui ; Liang, Changhong ; Xie, Yu ; Liu, Zaiyi</creatorcontrib><description>Objectives
To investigate whether breast edema characteristics at preoperative T2-weighted imaging (T2WI) could help evaluate axillary lymph node (ALN) burden in patients with early-stage breast cancer.
Methods
This retrospective study included women with clinical T1 and T2 stage breast cancer and preoperative MRI examination in two independent cohorts from May 2014 to December 2020. Low (< 3 LNs+) and high (≥ 3 LNs+) pathological ALN (pALN) burden were recorded as endpoint. Breast edema score (BES) was evaluated at T2WI. Univariable and multivariable analyses were performed by the logistic regression model. The added predictive value of BES was examined utilizing the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
Results
A total of 1092 patients were included in this study. BES was identified as the independent predictor of pALN burden in primary (
n
= 677) and validation (
n
= 415) cohorts. The analysis using MRI-ALN status showed that BES significantly improved the predictive performance of pALN burden (AUC: 0.65 vs 0.71,
p
< 0.001; IDI = 0.045,
p
< 0.001; continuous NRI = 0.159,
p
= 0.050). These results were confirmed in the validation cohort (AUC: 0.64 vs 0.69,
p
= 0.009; IDI = 0.050,
p
< 0.001; continuous NRI = 0.213,
p
= 0.047). Furthermore, BES was positively correlated with biologically invasive clinicopathological factors (
p
< 0.05).
Conclusions
In individuals with early-stage breast cancer, preoperative MRI characteristics of breast edema could be a promising predictor for pALN burden, which may aid in treatment planning.
Key Points
• In this retrospective study of 1092 patients with early-stage breast cancer from two cohorts, the MRI characteristic of breast edema has independent and additive predictive value for assessing axillary lymph node burden
.
• Breast edema characteristics at T2WI positively correlated with biologically invasive clinicopathological factors, which may be useful for preoperative diagnosis and treatment planning for individual patients with breast cancer.</description><identifier>ISSN: 1432-1084</identifier><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-022-08896-z</identifier><identifier>PMID: 35704112</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Axilla - pathology ; Breast ; Breast cancer ; Breast Diseases - pathology ; Breast Neoplasms - complications ; Breast Neoplasms - diagnostic imaging ; Breast Neoplasms - pathology ; Diagnostic Radiology ; Edema ; Edema - diagnostic imaging ; Edema - pathology ; Female ; Humans ; Imaging ; Internal Medicine ; Interventional Radiology ; Invasiveness ; Lymph nodes ; Lymph Nodes - diagnostic imaging ; Lymph Nodes - pathology ; Lymphatic Metastasis - pathology ; Lymphatic system ; Magnetic resonance imaging ; Magnetic Resonance Imaging - methods ; Medicine ; Medicine & Public Health ; Neuroradiology ; Patients ; Performance prediction ; Radiology ; Reclassification ; Regression models ; Retrospective Studies ; Ultrasound</subject><ispartof>European radiology, 2022-12, Vol.32 (12), p.8213-8225</ispartof><rights>The Author(s), under exclusive licence to European Society of Radiology 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.. corrected publication 2022</rights><rights>2022. The Author(s), under exclusive licence to European Society of Radiology.</rights><rights>The Author(s), under exclusive licence to European Society of Radiology 2022. Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. corrected publication 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c441t-d6d05ad66ff25d0e8ca80a0291fc636ca4725f9e04731637955919e8c9e31c0e3</citedby><cites>FETCH-LOGICAL-c441t-d6d05ad66ff25d0e8ca80a0291fc636ca4725f9e04731637955919e8c9e31c0e3</cites><orcidid>0000-0003-3296-9759</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-022-08896-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-022-08896-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35704112$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Xu, Zeyan</creatorcontrib><creatorcontrib>Ding, Yingying</creatorcontrib><creatorcontrib>Zhao, Ke</creatorcontrib><creatorcontrib>Han, Chu</creatorcontrib><creatorcontrib>Shi, Zhenwei</creatorcontrib><creatorcontrib>Cui, Yanfen</creatorcontrib><creatorcontrib>Liu, Chunling</creatorcontrib><creatorcontrib>Lin, Huan</creatorcontrib><creatorcontrib>Pan, Xipeng</creatorcontrib><creatorcontrib>Li, Pinxiong</creatorcontrib><creatorcontrib>Chen, Minglei</creatorcontrib><creatorcontrib>Wang, Huihui</creatorcontrib><creatorcontrib>Deng, Xiaohui</creatorcontrib><creatorcontrib>Liang, Changhong</creatorcontrib><creatorcontrib>Xie, Yu</creatorcontrib><creatorcontrib>Liu, Zaiyi</creatorcontrib><title>MRI characteristics of breast edema for assessing axillary lymph node burden in early-stage breast cancer: a retrospective bicentric study</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Objectives
To investigate whether breast edema characteristics at preoperative T2-weighted imaging (T2WI) could help evaluate axillary lymph node (ALN) burden in patients with early-stage breast cancer.
Methods
This retrospective study included women with clinical T1 and T2 stage breast cancer and preoperative MRI examination in two independent cohorts from May 2014 to December 2020. Low (< 3 LNs+) and high (≥ 3 LNs+) pathological ALN (pALN) burden were recorded as endpoint. Breast edema score (BES) was evaluated at T2WI. Univariable and multivariable analyses were performed by the logistic regression model. The added predictive value of BES was examined utilizing the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
Results
A total of 1092 patients were included in this study. BES was identified as the independent predictor of pALN burden in primary (
n
= 677) and validation (
n
= 415) cohorts. The analysis using MRI-ALN status showed that BES significantly improved the predictive performance of pALN burden (AUC: 0.65 vs 0.71,
p
< 0.001; IDI = 0.045,
p
< 0.001; continuous NRI = 0.159,
p
= 0.050). These results were confirmed in the validation cohort (AUC: 0.64 vs 0.69,
p
= 0.009; IDI = 0.050,
p
< 0.001; continuous NRI = 0.213,
p
= 0.047). Furthermore, BES was positively correlated with biologically invasive clinicopathological factors (
p
< 0.05).
Conclusions
In individuals with early-stage breast cancer, preoperative MRI characteristics of breast edema could be a promising predictor for pALN burden, which may aid in treatment planning.
Key Points
• In this retrospective study of 1092 patients with early-stage breast cancer from two cohorts, the MRI characteristic of breast edema has independent and additive predictive value for assessing axillary lymph node burden
.
• Breast edema characteristics at T2WI positively correlated with biologically invasive clinicopathological factors, which may be useful for preoperative diagnosis and treatment planning for individual patients with breast cancer.</description><subject>Axilla - pathology</subject><subject>Breast</subject><subject>Breast cancer</subject><subject>Breast Diseases - pathology</subject><subject>Breast Neoplasms - complications</subject><subject>Breast Neoplasms - diagnostic imaging</subject><subject>Breast Neoplasms - pathology</subject><subject>Diagnostic Radiology</subject><subject>Edema</subject><subject>Edema - diagnostic imaging</subject><subject>Edema - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional Radiology</subject><subject>Invasiveness</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - diagnostic imaging</subject><subject>Lymph Nodes - pathology</subject><subject>Lymphatic Metastasis - pathology</subject><subject>Lymphatic system</subject><subject>Magnetic resonance imaging</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroradiology</subject><subject>Patients</subject><subject>Performance prediction</subject><subject>Radiology</subject><subject>Reclassification</subject><subject>Regression models</subject><subject>Retrospective Studies</subject><subject>Ultrasound</subject><issn>1432-1084</issn><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kctuFDEQRS0EIiHwAyyQJTZsGsqPbrfZoYhApCAkBGvLY1dPHPVjcLkRk0_gq2OYBBALVrZUp66rfBh7KuClADCvCEApaEDKBvreds31PXYstJKNgF7f_-t-xB4RXQGAFdo8ZEeqNaCFkMfsx4dP5zxc-uxDwZyopEB8Gfgmo6fCMeLk-bBk7omQKM1b7r-ncfR5z8f9tLvk8xKRb9YcceZp5ujzuG-o-C3ehQQ_B8yvuecZS15oh6Gkb7WcAs4lp8CprHH_mD0Y_Ej45PY8YV_O3n4-fd9cfHx3fvrmoglai9LELkLrY9cNg2wjYB98Dx6kFUPoVBe8NrIdLII2SnTK2La1wlbMohIBUJ2wF4fcXV6-rkjFTYkC1p1mXFZysjOdlbK1pqLP_0GvljXPdTonjQajlZa2UvJAhbocZRzcLqep_pAT4H6acgdTrppyv0y569r07DZ63UwYf7fcqamAOgBUS_MW85-3_xN7A5CeoIg</recordid><startdate>20221201</startdate><enddate>20221201</enddate><creator>Xu, Zeyan</creator><creator>Ding, Yingying</creator><creator>Zhao, Ke</creator><creator>Han, Chu</creator><creator>Shi, Zhenwei</creator><creator>Cui, Yanfen</creator><creator>Liu, Chunling</creator><creator>Lin, Huan</creator><creator>Pan, Xipeng</creator><creator>Li, Pinxiong</creator><creator>Chen, Minglei</creator><creator>Wang, Huihui</creator><creator>Deng, Xiaohui</creator><creator>Liang, Changhong</creator><creator>Xie, Yu</creator><creator>Liu, Zaiyi</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3296-9759</orcidid></search><sort><creationdate>20221201</creationdate><title>MRI characteristics of breast edema for assessing axillary lymph node burden in early-stage breast cancer: a retrospective bicentric study</title><author>Xu, Zeyan ; Ding, Yingying ; Zhao, Ke ; Han, Chu ; Shi, Zhenwei ; Cui, Yanfen ; Liu, Chunling ; Lin, Huan ; Pan, Xipeng ; Li, Pinxiong ; Chen, Minglei ; Wang, Huihui ; Deng, Xiaohui ; Liang, Changhong ; Xie, Yu ; Liu, Zaiyi</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c441t-d6d05ad66ff25d0e8ca80a0291fc636ca4725f9e04731637955919e8c9e31c0e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Axilla - pathology</topic><topic>Breast</topic><topic>Breast cancer</topic><topic>Breast Diseases - pathology</topic><topic>Breast Neoplasms - complications</topic><topic>Breast Neoplasms - diagnostic imaging</topic><topic>Breast Neoplasms - pathology</topic><topic>Diagnostic Radiology</topic><topic>Edema</topic><topic>Edema - diagnostic imaging</topic><topic>Edema - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional Radiology</topic><topic>Invasiveness</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - diagnostic imaging</topic><topic>Lymph Nodes - pathology</topic><topic>Lymphatic Metastasis - pathology</topic><topic>Lymphatic system</topic><topic>Magnetic resonance imaging</topic><topic>Magnetic Resonance Imaging - methods</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroradiology</topic><topic>Patients</topic><topic>Performance prediction</topic><topic>Radiology</topic><topic>Reclassification</topic><topic>Regression models</topic><topic>Retrospective Studies</topic><topic>Ultrasound</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Xu, Zeyan</creatorcontrib><creatorcontrib>Ding, Yingying</creatorcontrib><creatorcontrib>Zhao, Ke</creatorcontrib><creatorcontrib>Han, Chu</creatorcontrib><creatorcontrib>Shi, Zhenwei</creatorcontrib><creatorcontrib>Cui, Yanfen</creatorcontrib><creatorcontrib>Liu, Chunling</creatorcontrib><creatorcontrib>Lin, Huan</creatorcontrib><creatorcontrib>Pan, Xipeng</creatorcontrib><creatorcontrib>Li, Pinxiong</creatorcontrib><creatorcontrib>Chen, Minglei</creatorcontrib><creatorcontrib>Wang, Huihui</creatorcontrib><creatorcontrib>Deng, Xiaohui</creatorcontrib><creatorcontrib>Liang, Changhong</creatorcontrib><creatorcontrib>Xie, Yu</creatorcontrib><creatorcontrib>Liu, Zaiyi</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Xu, Zeyan</au><au>Ding, Yingying</au><au>Zhao, Ke</au><au>Han, Chu</au><au>Shi, Zhenwei</au><au>Cui, Yanfen</au><au>Liu, Chunling</au><au>Lin, Huan</au><au>Pan, Xipeng</au><au>Li, Pinxiong</au><au>Chen, Minglei</au><au>Wang, Huihui</au><au>Deng, Xiaohui</au><au>Liang, Changhong</au><au>Xie, Yu</au><au>Liu, Zaiyi</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>MRI characteristics of breast edema for assessing axillary lymph node burden in early-stage breast cancer: a retrospective bicentric study</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2022-12-01</date><risdate>2022</risdate><volume>32</volume><issue>12</issue><spage>8213</spage><epage>8225</epage><pages>8213-8225</pages><issn>1432-1084</issn><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Objectives
To investigate whether breast edema characteristics at preoperative T2-weighted imaging (T2WI) could help evaluate axillary lymph node (ALN) burden in patients with early-stage breast cancer.
Methods
This retrospective study included women with clinical T1 and T2 stage breast cancer and preoperative MRI examination in two independent cohorts from May 2014 to December 2020. Low (< 3 LNs+) and high (≥ 3 LNs+) pathological ALN (pALN) burden were recorded as endpoint. Breast edema score (BES) was evaluated at T2WI. Univariable and multivariable analyses were performed by the logistic regression model. The added predictive value of BES was examined utilizing the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).
Results
A total of 1092 patients were included in this study. BES was identified as the independent predictor of pALN burden in primary (
n
= 677) and validation (
n
= 415) cohorts. The analysis using MRI-ALN status showed that BES significantly improved the predictive performance of pALN burden (AUC: 0.65 vs 0.71,
p
< 0.001; IDI = 0.045,
p
< 0.001; continuous NRI = 0.159,
p
= 0.050). These results were confirmed in the validation cohort (AUC: 0.64 vs 0.69,
p
= 0.009; IDI = 0.050,
p
< 0.001; continuous NRI = 0.213,
p
= 0.047). Furthermore, BES was positively correlated with biologically invasive clinicopathological factors (
p
< 0.05).
Conclusions
In individuals with early-stage breast cancer, preoperative MRI characteristics of breast edema could be a promising predictor for pALN burden, which may aid in treatment planning.
Key Points
• In this retrospective study of 1092 patients with early-stage breast cancer from two cohorts, the MRI characteristic of breast edema has independent and additive predictive value for assessing axillary lymph node burden
.
• Breast edema characteristics at T2WI positively correlated with biologically invasive clinicopathological factors, which may be useful for preoperative diagnosis and treatment planning for individual patients with breast cancer.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>35704112</pmid><doi>10.1007/s00330-022-08896-z</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0003-3296-9759</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1432-1084 |
| ispartof | European radiology, 2022-12, Vol.32 (12), p.8213-8225 |
| issn | 1432-1084 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2676922597 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Axilla - pathology Breast Breast cancer Breast Diseases - pathology Breast Neoplasms - complications Breast Neoplasms - diagnostic imaging Breast Neoplasms - pathology Diagnostic Radiology Edema Edema - diagnostic imaging Edema - pathology Female Humans Imaging Internal Medicine Interventional Radiology Invasiveness Lymph nodes Lymph Nodes - diagnostic imaging Lymph Nodes - pathology Lymphatic Metastasis - pathology Lymphatic system Magnetic resonance imaging Magnetic Resonance Imaging - methods Medicine Medicine & Public Health Neuroradiology Patients Performance prediction Radiology Reclassification Regression models Retrospective Studies Ultrasound |
| title | MRI characteristics of breast edema for assessing axillary lymph node burden in early-stage breast cancer: a retrospective bicentric study |
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