Clinical imaging · 2025
Multiparametric MRI and clinical factors for predicting early recurrence of breast cancer after modified radical mastectomy.
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Chen Quan-Hua, Yang Chongze, Qin Lan-Hui, Liang Yan-Ling, Jiang Wei-Wei, Liao Jin-Yuan
Аннотация
OBJECTIVE: To determine whether preoperative multiparametric MRI features and clinicopathological factors can predict early recurrence in breast cancer patients following modified radical mastectomy (MRM).
MATERIALS AND METHODS: This retrospective study included 132 patients who underwent MRM at two hospitals from January 2012 to December 2022. Patients were classified into early recurrence (disease-free survival ≤3 years, n = 86) or late recurrence (>3 years, n = 46). We collected preoperative MRI features (tumor size, morphology, enhancement patterns, apparent diffusion coefficient (ADC) values, early enhancement rate, time-signal intensity curves) and clinical/pathological factors (age, menstruation status, neoadjuvant chemotherapy, T/N/TNM stage, tumor grade, axillary nodal involvement, vascular/nerve/nipple/skin invasion, ER, PR, HER-2, Ki-67, molecular subtype, and adjuvant therapies). Univariate and multivariate analyses (binary logistic and Cox regression) identified independent predictors of early recurrence and their impact on disease-free survival. Predictive accuracy was assessed by ROC curves.
RESULTS: Significant factors associated with early recurrence (P < 0.05) included tumor size, ADC value, early enhancement rate, axillary lymph node metastasis, T and TNM stage, vascular invasion, ER, PR, HER-2, molecular subtype, and endocrine therapy. Multivariate analysis identified early enhancement rate, lower ADC value, and larger tumor diameter as independent predictors (AUC = 0.899). These MRI factors, together with lack of endocrine therapy, also independently influenced disease-free survival.
CONCLUSION: Preoperative multiparametric MRI features, especially early enhancement rate and tumor size, combined with endocrine therapy status, can predict early recurrence, enhancing prognosis for patients undergoing MRM.
MATERIALS AND METHODS: This retrospective study included 132 patients who underwent MRM at two hospitals from January 2012 to December 2022. Patients were classified into early recurrence (disease-free survival ≤3 years, n = 86) or late recurrence (>3 years, n = 46). We collected preoperative MRI features (tumor size, morphology, enhancement patterns, apparent diffusion coefficient (ADC) values, early enhancement rate, time-signal intensity curves) and clinical/pathological factors (age, menstruation status, neoadjuvant chemotherapy, T/N/TNM stage, tumor grade, axillary nodal involvement, vascular/nerve/nipple/skin invasion, ER, PR, HER-2, Ki-67, molecular subtype, and adjuvant therapies). Univariate and multivariate analyses (binary logistic and Cox regression) identified independent predictors of early recurrence and their impact on disease-free survival. Predictive accuracy was assessed by ROC curves.
RESULTS: Significant factors associated with early recurrence (P < 0.05) included tumor size, ADC value, early enhancement rate, axillary lymph node metastasis, T and TNM stage, vascular invasion, ER, PR, HER-2, molecular subtype, and endocrine therapy. Multivariate analysis identified early enhancement rate, lower ADC value, and larger tumor diameter as independent predictors (AUC = 0.899). These MRI factors, together with lack of endocrine therapy, also independently influenced disease-free survival.
CONCLUSION: Preoperative multiparametric MRI features, especially early enhancement rate and tumor size, combined with endocrine therapy status, can predict early recurrence, enhancing prognosis for patients undergoing MRM.