Premium
Synchronous Breast Cancer: Phenotypic Similarities on MRI
Author(s) -
Wang Hui,
Velden Bas H.M.,
Chan Hui Shan M.,
Loo Claudette E.,
Viergever Max A.,
Gilhuijs Kenneth G.A.
Publication year - 2020
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.27026
Subject(s) - breast cancer , phenotype , cancer , medicine , oncology , population , nottingham prognostic index , wilcoxon signed rank test , stage (stratigraphy) , pathology , biology , mann–whitney u test , gene , genetics , paleontology , environmental health
Background Previous studies have shown discrepancies between index and synchronous breast cancer in histology and molecular phenotype. It is yet unknown whether this observation also applies to the MRI phenotype. Purpose To investigate whether the appearance of breast cancer on MRI (i.e. phenotype) is different from that of additional breast cancer (i.e. synchronous cancer), and whether such a difference, if it exists, is associated with prognosis. Study Type Retrospective. Population In all, 464 consecutive patients with early‐stage ER+/HER2– breast cancer were included; 34/464 (7.3%) had 44 synchronous cancers in total (34 ipsilateral, 10 contralateral). Sequence 1.5T, contrast‐enhanced T 1 ‐weighted. Assessment We assessed imaging phenotype using 50 quantitative features from each cancer and applied principal component analysis (PCA) to identify independent properties. The degree of phenotype difference was assessed. An association between phenotype differences and prognosis in terms of the Nottingham Prognostic Index (NPI) and PREDICT score were analyzed. Statistical Tests PCA; Wilcoxon rank sum test; Benjamini–Hochberg to control the false discovery rate. Results PCA identified eight components in patients with ipsilateral synchronous cancer. Six out of eight were significantly different between index and synchronous cancer. These components represented features describing texture (three components, P < 0.001, P < 0.001, P = 0.004), size ( P < 0.001), smoothness ( P < 0.001), and kinetics ( P = 0.004). Phenotype differences in terms of the six components were split in tertiles. Larger phenotype differences in size, kinetics, and texture were associated with significantly worse prognosis in terms of NPI ( P = 0.019, P = 0.045, P = 0.014), but not for the PREDICT score ( P = 0.109, P = 0.479, P = 0.109). PCA identified six components in patients with contralateral synchronous cancer. None were significantly different from the index cancer ( P = 0.178, P = 0.178, P = 0.178, P = 0.326, P = 0.739, P = 0.423). Data Conclusion The MRI phenotype of ER+/HER2– breast cancer was different from that of ipsilateral synchronous cancer and a large phenotype difference was associated with worse prognosis. No significant difference was found for synchronous contralateral cancer. Level of Evidence: 3 Technical Efficacy: Stage 4 J. Magn. Reson. Imaging 2020;51:1858–1867.