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Investigation of the Correlation between Different DCE-MRI Enhancement Patterns and Lymphovascular Invasion in
Shiqi Guo1, Boning Zhou2, Jiahong Sun1
1The Chinese People's Liberation Army (PLA) Medical College, Beijing 100853, China (S.G., B.Z., J.S., Q.L., S.C.); Department of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China (S.G., J.S., Y.X., Q.L., S.C., Z.G., J.W.).
Rationale And Objectives:
This study aims to compare the breast magnetic resonance imaging (MRI) features and clinicopathological characteristics of invasive breast cancer patients with different enhancement patterns, and to investigate the relationship between enhancement patterns and lymphovascular invasion (LVI).
Materials And Methods:
This retrospective study consecutively enrolled 1185 female patients with invasive breast cancer who underwent dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) at our institution. Propensity score matching (PSM) was employed to match patients between mass enhancement (ME) group and non-mass enhancement (NME) group. With the occurrence of LVI as the clinical endpoint, covariates with a standardized mean difference (SMD) greater than 0.1 and the enhancement patterns were incorporated into a Firth's bias-reduced logistic regression analysis to further evaluate the relationship between enhancement patterns and LVI.
Results:
Compared to the ME group, lesions in the NME group demonstrated significantly higher rates of axillary lymph node positivity and LVI (both P<0.001). After PSM, differences in ADC values and the distribution of the triple-negative subtype persisted between the two groups. Firth regression analysis identified NME as a risk factor for LVI (P<0.001). Compared to the Luminal A subtype, the Luminal B (P<0.001), HER2-positive (P<0.001), and triple-negative (P=0.001) subtypes were all associated with a significantly increased risk of LVI. ADC value did not demonstrate a significant association with LVI (P=0.537).
Conclusion:
NME was identified as a significant independent risk factor for LVI. Compared to the Luminal A subtype, the Luminal B, HER2-positive, and triple-negative subtypes were all associated with a significantly increased risk of LVI. The ADC value did not demonstrate a significant association with LVI.
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