Retrospective analysis of preoperative breast MRI of breast cancer patients with breast conserving surgery

doi:10.3969/j.issn.1006-7795.2020.06.013

Abstract

Abstract: Objective To investigate the clinical value of breast magnetic resonance imaging (MRI) for breast cancer patients with breast conserving surgery (BCS). Methods The data of 236 patients with breast cancer confirmed by pathology were retrospectively analyzed, which included preoperative breast MRI, ultrasound, mammography and pathological information. Logistics regression analysis was used to analyze the relationship between preoperative imaging characteristics and pathological status of BCS margin after breast conserving surgery with SPSS software (version 22.0, Statacorp). Results The detection rates of breast lesions by MRI and mammography were 100% and 87.44% respectively. Ultrasound and mammography underestimated breast cancer with tumor size >2cm, while MRI overestimated breast cancer with tumor size ≤2 cm (P<0.05). The BCS margin was positive in 31 cases, of which 17 cases were positive in re-excision margin and 14 cases were negative. The success rate of breast conserving was 89.41%.The morphology and adjacent vascular signs of lesions on breast MRI,multiple lesions in ultrasound, pathological tumor size (Pathmd), HER-2 over-expression type(HR-), and HER-2 positive status were correlated with positive surgical margin(P<0.05). Multivariate analysis revealed that the “MASS & present” type, “NME” type, the present of adjacent multiple punctate vessel signs on breast MRI, and HER-2 over-expression type(HR-) were independent risk factor of positive surgical margin, OR(95%CI):39.472(9.835-158.421), P<0.001; 56.722(7.908-406.838), P<0.001; 24.076(4.979-116.413), P<0.001; 23.170(1.823-294.504), P=0.015. The success rate of breast conserving surgery in the low risk group without risk factors was 98.7%, which was significantly higher than that in the high-risk group with any risk factors of MRI (P<0.001). Conclusions MRI examination is one of the important methods for preoperative examination and evaluation of breast cancer. The “MASS & present” type, “NME” type, the present of adjacent multiple punctate vessel signs on breast MRI, and HER-2 over-expression type(HR-) are significantly associated with a positive resection margin in patients with breast cancer. The success rate of breast conserving surgery is high in breast cancer patients without risk factors.

Key words: breast, magnetic resonance imaging, breast cancer, breast conserving surgery, positive resection margin

CLC Number:

R737.9

Yang Yang, Kang Hua, Zhao Jing, Ling Yuwei, Zhao Ye, Wang Yajun, Rong Dongdong. Retrospective analysis of preoperative breast MRI of breast cancer patients with breast conserving surgery[J]. Journal of Capital Medical University, 2020, 41(6): 943-953.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2020.06.013

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2020/V41/I6/943

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