Skip to main content

Advertisement

Log in

Association between rim enhancement of breast cancer on dynamic contrast-enhanced MRI and patient outcome: impact of subtype

  • Clinical trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

The heterogeneous nature of breast cancer is represented by three breast cancer subtypes associated with different patient outcome. However, within subtypes, variations still exist. Additional stratification is necessary for more individualized therapy. Functional tumor characteristics on dynamic contrast-enhanced (DCE)-MRI may play a role. Rim enhancement of breast cancers has been associated with unfavorable pathology characteristics in the context of outcome. However, existence of a direct link is unknown. The purpose was to retrospectively determine the association between rim enhancement on DCE-MRI and long-term patient outcome, and whether it has complementary value to subtype. Preoperative DCE-MRI was performed in 556 consecutive female patients who were eligible for breast-conserving therapy. Presence of rim enhancement was assessed. Tumor characteristics were derived from resection specimens. Patients were stratified according to subtype. Association was assessed between rim enhancement and patient, pathology and treatment characteristics, recurrence-free interval and invasive disease-free survival. Median follow-up was 84 months. Patients were stratified into ER-positive/HER2-negative (N = 416), HER2-positive (N = 75), or triple-negative (N = 65) subtypes. Rim enhancement was seen in 29.0 % (N = 161/556) of tumors and was associated with higher histologic grade, negative ER-status, and triple-negative subtype. Only within triple-negative tumors, an association was seen with outcome. Recurrence was lower in non-rim-enhancing tumors (N = 1/36; 2.8 %) compared to rim-enhancing tumors (N = 9/28; 32.1 %) (p = 0.001). Survival was higher in non-rim-enhancing tumors (N = 34/36; 94.4 %) compared to rim-enhancing tumors (N = 18/28; 64.3 %) (p = 0.001). Rim enhancement on DCE-MRI is associated with long-term outcome of patients with triple-negative breast cancer and may potentially serve as a prognostic biomarker in these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Perou CM, Sorlie T, Eisen MB, van de Rijn M, Jeffrey SS et al (2000) Molecular portraits of human breast tumours. Nature 406:747–752

    Article  CAS  PubMed  Google Scholar 

  2. Sorlie T, Perou CM, Tibshirani R, Aas T, Geisler S et al (2001) Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 98:10869–10874

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Szabo BK, Aspelin P, Kristoffersen WM, Tot T, Bone B (2003) Invasive breast cancer: correlation of dynamic MR features with prognostic factors. Eur Radiol 13:2425–2435

    Article  PubMed  Google Scholar 

  4. Chang YW, Kwon KH, Choi DL, Lee DW, Lee MH et al (2009) Magnetic resonance imaging of breast cancer and correlation with prognostic factors. Acta Radiol 50:990–998

    Article  PubMed  Google Scholar 

  5. Narisada H, Aoki T, Sasaguri T, Hashimoto H, Konishi T et al (2006) Correlation between numeric gadolinium-enhanced dynamic MRI ratios and prognostic factors and histologic type of breast carcinoma. AJR Am J Roentgenol 187:297–306

    Article  PubMed  Google Scholar 

  6. Teifke A, Behr O, Schmidt M, Victor A, Vomweg TW et al (2006) Dynamic MR imaging of breast lesions: correlation with microvessel distribution pattern and histologic characteristics of prognosis. Radiology 239:351–360

    Article  PubMed  Google Scholar 

  7. Matsubayashi R, Matsuo Y, Edakuni G, Satoh T, Tokunaga O et al (2000) Breast masses with peripheral rim enhancement on dynamic contrast-enhanced MR images: correlation of MR findings with histologic features and expression of growth factors. Radiology 217:841–848

    Article  CAS  PubMed  Google Scholar 

  8. Lee SH, Cho N, Kim SJ, Cha JH, Cho KS et al (2008) Correlation between high resolution dynamic MR features and prognostic factors in breast cancer. Korean J Radiol 9:10–18

    Article  PubMed Central  PubMed  Google Scholar 

  9. Buadu LD, Murakami J, Murayama S, Hashiguchi N, Sakai S et al (1996) Breast lesions: correlation of contrast medium enhancement patterns on MR images with histopathologic findings and tumor angiogenesis. Radiology 200:639–649

    Article  CAS  PubMed  Google Scholar 

  10. Buadu LD, Murakami J, Murayama S, Hashiguchi N, Sakai S et al (1997) Patterns of peripheral enhancement in breast masses: correlation of findings on contrast medium enhanced MRI with histologic features and tumor angiogenesis. J Comput Assist Tomogr 21:421–430

    Article  CAS  PubMed  Google Scholar 

  11. Elshof LE, Rutgers EJ, Deurloo EE, Loo CE, Wesseling J et al (2010) A practical approach to manage additional lesions at preoperative breast MRI in patients eligible for breast conserving therapy: results. Breast Cancer Res Treat 124:707–715

    Article  PubMed  Google Scholar 

  12. American College of Radiology (ACR) (2003) Breast imaging reporting and data system (BI-RADS Atlas). American College of Radiology, Reston, VA

    Google Scholar 

  13. Deurloo EE, Tanis PJ, Gilhuijs KG, Muller SH, Kroger R et al (2003) Reduction in the number of sentinel lymph node procedures by preoperative ultrasonography of the axilla in breast cancer. Eur J Cancer 39:1068–1073

    Article  CAS  PubMed  Google Scholar 

  14. Egan RL (1982) Multicentric breast carcinomas: clinical-radiographic-pathologic whole organ studies and 10 year survival. Cancer 49:1123–1130

    Article  CAS  PubMed  Google Scholar 

  15. Rakha EA, El-Sayed ME, Lee AH, Elston CW, Grainge MJ et al (2008) Prognostic significance of Nottingham histologic grade in invasive breast carcinoma. J Clin Oncol 26:3153–3158

    Article  PubMed  Google Scholar 

  16. Hudis CA, Barlow WE, Costantino JP, Gray RJ, Pritchard KI et al (2007) Proposal for standardized definitions for efficacy end points in adjuvant breast cancer trials: the STEEP system. J Clin Oncol 25:2127–2132

    Article  PubMed  Google Scholar 

  17. Jiang L, Zhou Y, Wang Z, Lu X, Chen M et al (2013) Is there different correlation with prognostic factors between “non-mass” and “mass” type invasive ductal breast cancers? Eur J Radiol 82:1404–1409

    Article  PubMed  Google Scholar 

  18. Houssami N, Turner R, Macaskill P, Turnbull LW, McCready DR et al (2014) An individual person data meta-analysis of preoperative magnetic resonance imaging and breast cancer recurrence. J Clin Oncol 32:392–401

    Article  PubMed  Google Scholar 

  19. Pengel KE, Loo CE, Wesseling J, Pijnappel RM, Rutgers EJ et al (2014) Avoiding preoperative breast MRI when conventional imaging is sufficient to stage patients eligible for breast conserving therapy. Eur J Radiol 83:273–278

    Article  PubMed  Google Scholar 

  20. Hudis CA (2007) Trastuzumab—mechanism of action and use in clinical practice. N Engl J Med 357:39–51

    Article  CAS  PubMed  Google Scholar 

  21. Cleator S, Heller W, Coombes RC (2007) Triple-negative breast cancer: therapeutic options. Lancet Oncol 8:235–244

    Article  PubMed  Google Scholar 

  22. Bauer KR, Brown M, Cress RD, Parise CA, Caggiano V (2007) Descriptive analysis of estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-negative invasive breast cancer, the so-called triple-negative phenotype: a population-based study from the California cancer Registry. Cancer 109:1721–1728

    Article  PubMed  Google Scholar 

  23. Dent R, Trudeau M, Pritchard KI, Hanna WM, Kahn HK et al (2007) Triple-negative breast cancer: clinical features and patterns of recurrence. Clin Cancer Res 13:4429–4434

    Article  PubMed  Google Scholar 

  24. Liedtke C, Mazouni C, Hess KR, Andre F, Tordai A et al (2008) Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J Clin Oncol 26:1275–1281

    Article  PubMed  Google Scholar 

  25. Colpaert CG, Vermeulen PB, Fox SB, Harris AL, Dirix LY et al (2003) The presence of a fibrotic focus in invasive breast carcinoma correlates with the expression of carbonic anhydrase IX and is a marker of hypoxia and poor prognosis. Breast Cancer Res Treat 81:137–147

    Article  CAS  PubMed  Google Scholar 

  26. Hasebe T, Tsuda H, Hirohashi S, Shimosato Y, Tsubono Y et al (1998) Fibrotic focus in infiltrating ductal carcinoma of the breast: a significant histopathological prognostic parameter for predicting the long-term survival of the patients. Breast Cancer Res Treat 49:195–208

    Article  CAS  PubMed  Google Scholar 

  27. Colpaert C, Vermeulen P, van BP, Goovaerts G, Weyler J et al (2001) Intratumoral hypoxia resulting in the presence of a fibrotic focus is an independent predictor of early distant relapse in lymph node-negative breast cancer patients. Histopathology 39:416–425

    Article  CAS  PubMed  Google Scholar 

  28. Van den Eynden GG, Smid M, Van Laere SJ, Colpaert CG, Van dA I et al (2008) Gene expression profiles associated with the presence of a fibrotic focus and the growth pattern in lymph node-negative breast cancer. Clin Cancer Res 14:2944–2952

    Article  PubMed  Google Scholar 

  29. Carlson DJ, Keall PJ, Loo BW Jr, Chen ZJ, Brown JM (2011) Hypofractionation results in reduced tumor cell kill compared to conventional fractionation for tumors with regions of hypoxia. Int J Radiat Oncol Biol Phys 79:1188–1195

    Article  PubMed Central  PubMed  Google Scholar 

  30. Ferrara N (2004) Vascular endothelial growth factor as a target for anticancer therapy. Oncologist 9(Suppl 1):2–10

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

The study was conducted with financial support of The Dutch Pink Ribbon Foundation (http://www.pinkribbon.nl), Grant number 9684.2011.WO36.

Conflict of interest

The authors disclose no potential conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Alexander M. Th. Schmitz or Kenneth G. A. Gilhuijs.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Schmitz, A.M.T., Loo, C.E., Wesseling, J. et al. Association between rim enhancement of breast cancer on dynamic contrast-enhanced MRI and patient outcome: impact of subtype. Breast Cancer Res Treat 148, 541–551 (2014). https://doi.org/10.1007/s10549-014-3170-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-014-3170-9

Keywords

Navigation