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Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients

PURPOSE: In this study, we investigated the prognostic implications of focal breast edema on preoperative breast magnetic resonance imaging (MRI) in patients with breast cancer. METHODS: Data of 899 patients with breast cancer at a single institution were retrospectively analyzed. The patients were...

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Autores principales: Sung, Pamela, Lee, Jong Yoon, Cheun, Jong-Ho, Choi, In Sil, Park, Jin Hyun, Park, Jeong Hwan, Kim, Byoung Hyuck, Oh, Sohee, Chu, A Jung, Hwang, Ki-Tae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Breast Cancer Society 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625867/
https://www.ncbi.nlm.nih.gov/pubmed/37704381
http://dx.doi.org/10.4048/jbc.2023.26.e35
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author Sung, Pamela
Lee, Jong Yoon
Cheun, Jong-Ho
Choi, In Sil
Park, Jin Hyun
Park, Jeong Hwan
Kim, Byoung Hyuck
Oh, Sohee
Chu, A Jung
Hwang, Ki-Tae
author_facet Sung, Pamela
Lee, Jong Yoon
Cheun, Jong-Ho
Choi, In Sil
Park, Jin Hyun
Park, Jeong Hwan
Kim, Byoung Hyuck
Oh, Sohee
Chu, A Jung
Hwang, Ki-Tae
author_sort Sung, Pamela
collection PubMed
description PURPOSE: In this study, we investigated the prognostic implications of focal breast edema on preoperative breast magnetic resonance imaging (MRI) in patients with breast cancer. METHODS: Data of 899 patients with breast cancer at a single institution were retrospectively analyzed. The patients were divided into an edema-positive group (EPG) and an edema-negative group (ENG) based on the presence of peritumoral, prepectoral, or subcutaneous edema. Two radiologists evaluated the presence or absence of focal edema and its subtypes on preoperative breast MRI. Clinicopathologic characteristics and survival outcomes were compared between the two groups and among the three subtypes using Pearson’s χ(2) test, Kaplan–Meier estimator, and Cox proportional hazards model. RESULTS: There were 399 (44.4%) and 500 (55.6%) patients in the EPG and ENG, respectively. The EPG showed significantly higher rates of axillary lymph node metastasis (55.6% vs. 19.2%, p < 0.001) and lymphovascular invasion (LVI) (57.9% vs. 12.6%, p < 0.001) than the ENG. Patients in the EPG showed significantly worse overall survival (OS) rate (log-rank p < 0.001; hazard ratio [HR], 4.83; 95% confidence interval [CI], 2.56–9.11) and recurrence-free survival rate (log-rank p < 0.001; HR, 3.00; 95% CI, 1.94–4.63) than those in the ENG. After adjusting for other variables, focal breast edema remained a significant factor affecting the OS rate, regardless of the edema type. Specifically, the presence of subcutaneous edema emerged as the strongest predictor for OS with the highest HR (p < 0.001; HR, 9.10; 95% CI, 3.05–27.15). CONCLUSION: Focal breast edema on preoperative breast MRI implies a higher possibility of LVI and axillary lymph node metastasis, which can lead to a poor prognosis. A detailed description of focal breast edema, especially subcutaneous edema, on preoperative breast MRI may provide prognostic predictions. More intensive surveillance is required for patients with breast cancer and focal preoperative breast edema.
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spelling pubmed-106258672023-11-06 Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients Sung, Pamela Lee, Jong Yoon Cheun, Jong-Ho Choi, In Sil Park, Jin Hyun Park, Jeong Hwan Kim, Byoung Hyuck Oh, Sohee Chu, A Jung Hwang, Ki-Tae J Breast Cancer Original Article PURPOSE: In this study, we investigated the prognostic implications of focal breast edema on preoperative breast magnetic resonance imaging (MRI) in patients with breast cancer. METHODS: Data of 899 patients with breast cancer at a single institution were retrospectively analyzed. The patients were divided into an edema-positive group (EPG) and an edema-negative group (ENG) based on the presence of peritumoral, prepectoral, or subcutaneous edema. Two radiologists evaluated the presence or absence of focal edema and its subtypes on preoperative breast MRI. Clinicopathologic characteristics and survival outcomes were compared between the two groups and among the three subtypes using Pearson’s χ(2) test, Kaplan–Meier estimator, and Cox proportional hazards model. RESULTS: There were 399 (44.4%) and 500 (55.6%) patients in the EPG and ENG, respectively. The EPG showed significantly higher rates of axillary lymph node metastasis (55.6% vs. 19.2%, p < 0.001) and lymphovascular invasion (LVI) (57.9% vs. 12.6%, p < 0.001) than the ENG. Patients in the EPG showed significantly worse overall survival (OS) rate (log-rank p < 0.001; hazard ratio [HR], 4.83; 95% confidence interval [CI], 2.56–9.11) and recurrence-free survival rate (log-rank p < 0.001; HR, 3.00; 95% CI, 1.94–4.63) than those in the ENG. After adjusting for other variables, focal breast edema remained a significant factor affecting the OS rate, regardless of the edema type. Specifically, the presence of subcutaneous edema emerged as the strongest predictor for OS with the highest HR (p < 0.001; HR, 9.10; 95% CI, 3.05–27.15). CONCLUSION: Focal breast edema on preoperative breast MRI implies a higher possibility of LVI and axillary lymph node metastasis, which can lead to a poor prognosis. A detailed description of focal breast edema, especially subcutaneous edema, on preoperative breast MRI may provide prognostic predictions. More intensive surveillance is required for patients with breast cancer and focal preoperative breast edema. Korean Breast Cancer Society 2023-08-11 /pmc/articles/PMC10625867/ /pubmed/37704381 http://dx.doi.org/10.4048/jbc.2023.26.e35 Text en © 2023 Korean Breast Cancer Society https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Sung, Pamela
Lee, Jong Yoon
Cheun, Jong-Ho
Choi, In Sil
Park, Jin Hyun
Park, Jeong Hwan
Kim, Byoung Hyuck
Oh, Sohee
Chu, A Jung
Hwang, Ki-Tae
Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients
title Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients
title_full Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients
title_fullStr Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients
title_full_unstemmed Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients
title_short Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients
title_sort prognostic implication of focal breast edema on preoperative breast magnetic resonance imaging in breast cancer patients
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10625867/
https://www.ncbi.nlm.nih.gov/pubmed/37704381
http://dx.doi.org/10.4048/jbc.2023.26.e35
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