Evaluation of MRI accuracy after primary systemic therapy in breast cancer patients considering tumor biology: optimizing the surgical planning
, , , , and | May 08, 2019
About this article
Article Category: Research Article
Published Online: May 08, 2019
Page range: 171 - 177
Received: Dec 25, 2018
Accepted: Apr 18, 2019
DOI: https://doi.org/10.2478/raon-2019-0023
© 2019 Alberto Bouzón, Ángela Iglesias, Benigno Acea, Cristina Mosquera, Paz Santiago, Joaquín Mosquera, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.
Figure 1
Clinical and tumoral characteristics
| Variables | Mean | SD | Median | Range |
|---|---|---|---|---|
| Age (years) | 49.4 | 11.6 | 47.0 | 30.0–82.0 |
| Baseline tumor size (cm) | 3.9 | 1.9 | 3.4 | 1.2–12.0 |
| T1 | 21 | 10.3 | 5.9–14.7 | |
| Clinical tumor stage | T2 | 147 | 72.1 | 65.7–78.5 |
| T3 | 34 | 16.7 | 11.3–22.0 | |
| T4 | 2 | 0.9 | 0.1–3.5 | |
| Histological type | IDC | 196 | 96.1 | 93.2–99.0 |
| ILC | 8 | 3.9 | 1.0–6.8 | |
| low-medium | 60 | 30.0 | 23.4–36.6 | |
| Histological grade | high | 140 | 70.0 | 63.4–76.6 |
| NA | 4 | |||
| Hormonal receptor status | positive | 122 | 59.8 | 52.8–66.8 |
| negative | 82 | 40.2 | 33.2–47.2 | |
| HER2 status | positive | 75 | 36.8 | 29.9–43.6 |
| negative | 129 | 63.2 | 56.4–70.1 | |
| luminal B/HER2- | 77 | 37.7 | 30.8–44.6 | |
| luminal B/HER2+ | 45 | 22.1 | 16.1–28.0 | |
| Tumor subtype | HER2+ | 30 | 14.7 | 9.6–19.8 |
| triple negative | 52 | 25.5 | 19.3–31.7 | |
| Baseline axillary status | positive | 113 | 55.4 | 48.3–62.5 |
| negative | 91 | 44.6 | 37.5–51.7 |
Diagnostic accuracy of MRI to detect residual disease
| S (%) | SP (%) | PPV (%) | NPV (%) | ACC (%) | |
|---|---|---|---|---|---|
| 62.5 | 83.3 | 84.3 | 60.9 | 71.1 | |
| 64.2 | 100.0 | 100.0 | 29.4 | 68.8 | |
| 53.8 | 89.5 | 87.5 | 58.6 | 68.9 | |
| 42.9 | 73.9 | 33.3 | 80.9 | 66.7 | |
| 75.0 | 81.2 | 71.4 | 83.9 | 78.8 |
Factors affecting the MRI accuracy based on the discrepancy between MRI and pathologic residual tumor size. Univariate and multivariate analysis
| Variable | n* | Mean size discrepancy (± SD) | p | |
|---|---|---|---|---|
| 0.668 | ||||
| ≤45 | 88 | 0.72 (± 0.95) | ||
| >45 | 115 | 0.79 (± 1.43) | ||
| ≤5 | 167 | 0.62 (± 0.87) | ||
| >5 | 36 | 1.39 (± 2.18) | ||
| 0.347 | ||||
| IDC | 195 | 0.71 (± 1.02) | ||
| ILC | 8 | 2.05 (± 3.75) | ||
| Low-medium | 60 | 1.25 (± 1.82) | ||
| high | 139 | 0.55 (± 0.82) | ||
| 0.059 | ||||
| positive | 121 | 0.90 (± 1.38) | ||
| negative | 82 | 0.56 (± 0.97) | ||
| 0.956 | ||||
| positive | 74 | 0.75 (± 1.13) | ||
| negative | 129 | 0.76 (± 1.30) | ||
| 0.679 | 0.192 | 0.001 | 0.300–1.058 | |
| 0.214 | 0.181 | 0.239 | -0.143–0.570 | |
| 0.872 | 0.217 | <0.001 | 0.443–1.301 | |