Skip to main content
Top
Published in: Breast Cancer Research and Treatment 1/2020

01-05-2020 | Breast Cancer | Clinical trial

Peritumoral edema as a biomarker of the aggressiveness of breast cancer: results of a retrospective study on a 3 T scanner

Authors: Giovanna Panzironi, Giuliana Moffa, Francesca Galati, Flaminia Marzocca, Veronica Rizzo, Federica Pediconi

Published in: Breast Cancer Research and Treatment | Issue 1/2020

Login to get access

Abstract

Purpose

To determine whether there is a correlation between the presence of peritumoral edema detected on T2-weighted sequences and pathological prognostic factors and specific biological subtypes of breast cancer.

Methods

A retrospective study on 120 women with invasive breast cancer, who underwent breast MRI on a 3 T scanner over a period of 12 months, was performed. Peritumoral edema was assessed visually by two breast radiologist in consensus and patients were consequently divided into two groups. For each lesion dimensions, histology and molecular profiling were evaluated. The comparison between the two groups was performed using the χ2 test, subsequently carrying out a univariate and a multivariate logistic regression analysis.

Results

41 (34.2%) invasive breast cancers with perilesional edema and 79 (65.8%) without edema were identified. A significant association between the presence of perilesional edema and a larger lesion size (p = 0.0001), grade 3 (p < 0.001) and a higher Ki-67 index (p < 0.001) was found. The multivariate analysis confirmed that a larger tumor size is independently associated with peritumoral edema. A total of 101 (84.2%) luminal-like, 8 (6.7%) HER2-positive, and 11 (9.2%) triple-negative tumors were included in the study. Peritumoral edema turned out to be less frequently associated with luminal-like lesions (p < 0.001), while the luminal A status was found to have a significant association with the absence of peritumoral edema in the univariate analysis.

Conclusion

The detection of peritumoral edema on T2-weighted sequences should be considered as a valid additional prognostic tool in the evaluation of breast cancer, since it is associated with biologically aggressive non-luminal breast cancers, characterized by large dimension, high tumor grade, and high Ki-67 values.
Literature
1.
go back to reference Bray F, Ferlay J, Soerjomataram I et al (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 66:394–424CrossRef Bray F, Ferlay J, Soerjomataram I et al (2018) Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 66:394–424CrossRef
2.
go back to reference Mann RM, Balleyguier C, Baltzer PA et al (2015) Breast MRI: EUSOBI recommendations for women’s information. Eur Radiol 25:3669–3678CrossRef Mann RM, Balleyguier C, Baltzer PA et al (2015) Breast MRI: EUSOBI recommendations for women’s information. Eur Radiol 25:3669–3678CrossRef
3.
go back to reference Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316CrossRef Sardanelli F, Boetes C, Borisch B et al (2010) Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer 46:1296–1316CrossRef
4.
go back to reference Pinker K, Helbich TH, Morris EA (2017) The potential of multiparametric MRI of the breast. Br J Radiol 90:20160715CrossRef Pinker K, Helbich TH, Morris EA (2017) The potential of multiparametric MRI of the breast. Br J Radiol 90:20160715CrossRef
5.
go back to reference Uematsu T, Kasami M, Watanabe J (2014) Is evaluation of the presence of prepectoral edema on T2-weighted with fat-suppression 3 T breast MRI a simple and readily available noninvasive technique for estimation of prognosis in patients with breast cancer? Breast Cancer 21:684–692CrossRef Uematsu T, Kasami M, Watanabe J (2014) Is evaluation of the presence of prepectoral edema on T2-weighted with fat-suppression 3 T breast MRI a simple and readily available noninvasive technique for estimation of prognosis in patients with breast cancer? Breast Cancer 21:684–692CrossRef
7.
go back to reference Arponen O, Masarwah A, Sutela A et al (2016) Incidentally detected enhancing lesions found in breast MRI: analysis of apparent diffusion coefficient and T2 signal intensity significantly improves specificity. Eur Radiol 26:4361–4370CrossRef Arponen O, Masarwah A, Sutela A et al (2016) Incidentally detected enhancing lesions found in breast MRI: analysis of apparent diffusion coefficient and T2 signal intensity significantly improves specificity. Eur Radiol 26:4361–4370CrossRef
8.
go back to reference Uematsu T (2015) Focal breast edema associated with malignancy on T2-weighted images of breast MRI: peritumoral edema, prepectoral edema, and subcutaneous edema. Breast Cancer 22:66–70CrossRef Uematsu T (2015) Focal breast edema associated with malignancy on T2-weighted images of breast MRI: peritumoral edema, prepectoral edema, and subcutaneous edema. Breast Cancer 22:66–70CrossRef
9.
go back to reference Baltzer PA, Dietzel M, Kaiser WA (2011) Nonmass lesions in magnetic resonance imaging of the breast: additional T2-weighted images improve diagnostic accuracy. J Comput Assist Tomogr 35:361–366CrossRef Baltzer PA, Dietzel M, Kaiser WA (2011) Nonmass lesions in magnetic resonance imaging of the breast: additional T2-weighted images improve diagnostic accuracy. J Comput Assist Tomogr 35:361–366CrossRef
10.
go back to reference Kawashima H, Kobayashi-Yoshida M, Matsui O et al (2010) Peripheral hyperintense pattern on T2-weighted magnetic resonance imaging (MRI) in breast carcinoma: correlation with early peripheral enhancement on dynamic MRI and histopathologic findings. J Magn Reson Imaging 32:1117–1123CrossRef Kawashima H, Kobayashi-Yoshida M, Matsui O et al (2010) Peripheral hyperintense pattern on T2-weighted magnetic resonance imaging (MRI) in breast carcinoma: correlation with early peripheral enhancement on dynamic MRI and histopathologic findings. J Magn Reson Imaging 32:1117–1123CrossRef
11.
go back to reference Baltzer PA, Yang F, Dietzel M et al (2010) Sensitivity and specificity of unilateral edema on T2w-TSE sequences in MR-Mammography considering 974 histologically verified lesions. Breast J 16:233–239CrossRef Baltzer PA, Yang F, Dietzel M et al (2010) Sensitivity and specificity of unilateral edema on T2w-TSE sequences in MR-Mammography considering 974 histologically verified lesions. Breast J 16:233–239CrossRef
12.
go back to reference Cx Wu, Lin GS, Lin ZX et al (2015) Peritumoral edema on magnetic resonance imaging predicts a poor clinical outcome in malignant glioma. Oncol Lett 10:2769–2776CrossRef Cx Wu, Lin GS, Lin ZX et al (2015) Peritumoral edema on magnetic resonance imaging predicts a poor clinical outcome in malignant glioma. Oncol Lett 10:2769–2776CrossRef
13.
go back to reference Schoenegger K, Oberndorfer S, Wuschitz B et al (2009) Peritumoral edema on MRI at initial diagnosis: an independent prognostic factor for glioblastoma? Eur J Neurol 16:874–878CrossRef Schoenegger K, Oberndorfer S, Wuschitz B et al (2009) Peritumoral edema on MRI at initial diagnosis: an independent prognostic factor for glioblastoma? Eur J Neurol 16:874–878CrossRef
14.
go back to reference Schmitz AM, Loo CE, Wesseling J et al (2014) Association between rim enhancement of breast cancer on dynamic contrast-enhanced MRI and patient outcome: impact of subtype. Breast Cancer Res Treat 148:541–551CrossRef Schmitz AM, Loo CE, Wesseling J et al (2014) Association between rim enhancement of breast cancer on dynamic contrast-enhanced MRI and patient outcome: impact of subtype. Breast Cancer Res Treat 148:541–551CrossRef
15.
go back to reference Costantini M, Belli P, Distefano D et al (2012) Magnetic resonance imaging features in triple-negative breast cancer: comparison with luminal and HER2-overexpressing tumors. Clin Breast Cancer 12:331–339CrossRef Costantini M, Belli P, Distefano D et al (2012) Magnetic resonance imaging features in triple-negative breast cancer: comparison with luminal and HER2-overexpressing tumors. Clin Breast Cancer 12:331–339CrossRef
16.
go back to reference Song SE, Shin SU, Moon HG et al (2017) MR imaging features associated with distant metastasis-free survival of patients with invasive breast cancer: a case–control study. Breast Cancer Res Treat 162:559–569CrossRef Song SE, Shin SU, Moon HG et al (2017) MR imaging features associated with distant metastasis-free survival of patients with invasive breast cancer: a case–control study. Breast Cancer Res Treat 162:559–569CrossRef
17.
go back to reference Goldhirsch A, Winer EP, Coates AS et al (2013) Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 24:2206–2223CrossRef Goldhirsch A, Winer EP, Coates AS et al (2013) Personalizing the treatment of women with early breast cancer: highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013. Ann Oncol 24:2206–2223CrossRef
18.
go back to reference Morris EA, Comstock CE, Lee CH et al. (2013) ACR BI-RADS Magnetic Resonance Imaging. In: ACR BI-RADS atlas, breast imaging reporting and data system, 5th edn. American College of Radiology, Reston Morris EA, Comstock CE, Lee CH et al. (2013) ACR BI-RADS Magnetic Resonance Imaging. In: ACR BI-RADS atlas, breast imaging reporting and data system, 5th edn. American College of Radiology, Reston
19.
go back to reference Fitzgibbons PL, Murphy DA, Hammond ME et al (2010) Recommendations for validating estrogen and progesterone receptor immunohistochemistry assays. Arch Pathol Lab Med 134:930–935PubMed Fitzgibbons PL, Murphy DA, Hammond ME et al (2010) Recommendations for validating estrogen and progesterone receptor immunohistochemistry assays. Arch Pathol Lab Med 134:930–935PubMed
20.
go back to reference Marino MA, Helbich T, Baltzer P et al (2018) Multiparametric MRI of the breast: a review. J Magn Reson Imaging 47:301–315CrossRef Marino MA, Helbich T, Baltzer P et al (2018) Multiparametric MRI of the breast: a review. J Magn Reson Imaging 47:301–315CrossRef
21.
go back to reference Mann RM, Cho N, Moy L (2019) Breast MRI: state of the art. Radiology 292:520–536CrossRef Mann RM, Cho N, Moy L (2019) Breast MRI: state of the art. Radiology 292:520–536CrossRef
22.
go back to reference Galati F, Luciani ML, Caramanico C et al (2019) Breast magnetic resonance spectroscopy at 3 T in biopsy-proven breast cancers: does Choline peak correlate with prognostic factors? Invest Radiol 54:767–773CrossRef Galati F, Luciani ML, Caramanico C et al (2019) Breast magnetic resonance spectroscopy at 3 T in biopsy-proven breast cancers: does Choline peak correlate with prognostic factors? Invest Radiol 54:767–773CrossRef
23.
go back to reference Ballesio L, Savelli S, Angeletti M et al (2009) Breast MRI: are T2 IR sequences useful in the evaluation of breast lesions? Eur J Radiol 71:96–101CrossRef Ballesio L, Savelli S, Angeletti M et al (2009) Breast MRI: are T2 IR sequences useful in the evaluation of breast lesions? Eur J Radiol 71:96–101CrossRef
24.
go back to reference Westra C, Dialani V, Mehta TS, at al. (2014) Using T2-weighted sequences to more accurately characterize breast masses seen on MRI. AJR Am J Roentgenol 202:W183–190CrossRef Westra C, Dialani V, Mehta TS, at al. (2014) Using T2-weighted sequences to more accurately characterize breast masses seen on MRI. AJR Am J Roentgenol 202:W183–190CrossRef
25.
go back to reference Gutman DA, Cooper LA, Hwang SN et al (2013) MR imaging predictors of molecular profile and survival: multi-institutional study of the TCGA glioblastoma data set. Radiology 267:560–569CrossRef Gutman DA, Cooper LA, Hwang SN et al (2013) MR imaging predictors of molecular profile and survival: multi-institutional study of the TCGA glioblastoma data set. Radiology 267:560–569CrossRef
26.
go back to reference Hou J, Kshettry VR, Selman WR et al (2013) Peritumoral brain edema in intracranial meningiomas: the emergence of vascular endothelial growth factor-directed therapy. Neurosurg Focus 35:E2CrossRef Hou J, Kshettry VR, Selman WR et al (2013) Peritumoral brain edema in intracranial meningiomas: the emergence of vascular endothelial growth factor-directed therapy. Neurosurg Focus 35:E2CrossRef
27.
go back to reference Cheon H, Kim HJ, Kim TH et al (2018) Invasive breast cancer: prognostic value of peritumoral edema identified at preoperative MR imaging. Radiology 287:68–75CrossRef Cheon H, Kim HJ, Kim TH et al (2018) Invasive breast cancer: prognostic value of peritumoral edema identified at preoperative MR imaging. Radiology 287:68–75CrossRef
28.
go back to reference Bae MS, Shin SU, Ryu HS et al (2016) Pretreatment MR imaging features of triple-negative breast cancer: association with Response to neoadjuvant chemotherapy and recurrence-free survival. Radiology 281:392–400CrossRef Bae MS, Shin SU, Ryu HS et al (2016) Pretreatment MR imaging features of triple-negative breast cancer: association with Response to neoadjuvant chemotherapy and recurrence-free survival. Radiology 281:392–400CrossRef
29.
go back to reference Dietzel M, Baltzer PA, Vag T et al (2010) Magnetic resonance mammography of invasive lobular versus ductal carcinoma: systematic comparison of 811 patients reveals high diagnostic accuracy irrespective of typing. J Comput Assist Tomogr 34:587–595CrossRef Dietzel M, Baltzer PA, Vag T et al (2010) Magnetic resonance mammography of invasive lobular versus ductal carcinoma: systematic comparison of 811 patients reveals high diagnostic accuracy irrespective of typing. J Comput Assist Tomogr 34:587–595CrossRef
30.
go back to reference Tang P, Tse GM (2016) Immunohistochemical surrogates for molecular classification of breast carcinoma: a 2015 update. Arch Pathol Lab Med 140:806–814CrossRef Tang P, Tse GM (2016) Immunohistochemical surrogates for molecular classification of breast carcinoma: a 2015 update. Arch Pathol Lab Med 140:806–814CrossRef
31.
go back to reference Trimboli RM, Verardi N, Cartia F et al (2014) Breast cancer detection using double reading of unenhanced MRI including T1-weighted, T2-weighted STIR, and diffusion-wighted imaging: a proof of concept study. AJR Am J Roentgenol 203:674–681CrossRef Trimboli RM, Verardi N, Cartia F et al (2014) Breast cancer detection using double reading of unenhanced MRI including T1-weighted, T2-weighted STIR, and diffusion-wighted imaging: a proof of concept study. AJR Am J Roentgenol 203:674–681CrossRef
Metadata
Title
Peritumoral edema as a biomarker of the aggressiveness of breast cancer: results of a retrospective study on a 3 T scanner
Authors
Giovanna Panzironi
Giuliana Moffa
Francesca Galati
Flaminia Marzocca
Veronica Rizzo
Federica Pediconi
Publication date
01-05-2020
Publisher
Springer US
Published in
Breast Cancer Research and Treatment / Issue 1/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI
https://doi.org/10.1007/s10549-020-05592-8

Other articles of this Issue 1/2020

Breast Cancer Research and Treatment 1/2020 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine