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Updated: Sep 20, 2025

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Computer-Aided Diagnosis of ER-positive, HER2-Negative Breast Cancer on Dynamic Contrast-Enhanced MRI: Associations

Jin Joo Kim1, Jin You Kim1, Lee Hwangbo1

  • 1Department of Radiology, Biomedical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, Busan, Republic of Korea.

Clinical Breast Cancer
|May 24, 2025
PubMed
Summary
This summary is machine-generated.

Computer-aided diagnosis (CAD) kinetic heterogeneity on dynamic contrast-enhanced MRI is linked to higher breast cancer recurrence risk in ER-positive, HER2-negative patients. This finding aids in predicting recurrence for personalized treatment strategies.

Keywords:
BreastCancerKineticsMagnetic resonance imagingOncotype DX

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Area of Science:

  • Oncology
  • Radiology
  • Medical Imaging

Background:

  • Estrogen receptor-positive (ER-positive), human epidermal growth factor receptor 2-negative (HER2-negative) invasive breast cancer requires accurate risk stratification.
  • The Oncotype DX assay provides a recurrence score (RS) but additional imaging biomarkers may improve risk prediction.
  • Dynamic contrast-enhanced MRI (DCE-MRI) offers insights into tumor vascularity and heterogeneity.

Purpose of the Study:

  • To determine if kinetic features and heterogeneity from computer-aided diagnosis (CAD) on DCE-MRI correlate with breast cancer recurrence risk.
  • To assess the association between CAD-derived kinetic parameters and Oncotype DX assay results in ER-positive, HER2-negative breast cancer.

Main Methods:

  • Retrospective analysis of 227 women with ER-positive, HER2-negative breast cancer who underwent preoperative MRI and Oncotype DX assay.
  • Assessment of enhancement kinetic parameters and kinetic heterogeneity using a CAD system.
  • Correlation of imaging features with Oncotype DX recurrence scores (RS).

Main Results:

  • Higher kinetic heterogeneity on CAD was significantly associated with a high Oncotype DX RS (≥ 26) compared to non-high-risk groups.
  • Multivariate analysis identified higher kinetic heterogeneity (OR 12.57), high histologic grade (OR 21.30), progesterone receptor negativity (OR 21.30), and higher Ki-67 (OR 21.30) as predictors of high recurrence risk.

Conclusions:

  • Increased kinetic heterogeneity identified by CAD on DCE-MRI is a significant imaging biomarker associated with a higher risk of breast cancer recurrence.
  • These findings suggest that DCE-MRI-derived kinetic heterogeneity may complement genomic assays like Oncotype DX for risk stratification.