Imaging Phenotypes in Women at High Risk for Breast Cancer on Mammography, Ultrasound, and Magnetic Resonance Imaging Using the Fifth Edition of the Breast Imaging Reporting and Data System
Imaging Phenotypes in Women at High Risk for Breast Cancer on Mammography, Ultrasound, and Magnetic Resonance Imaging Using the Fifth Edition of the Breast Imaging Reporting and Data System
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DOI：
10.1016/j.ejrad.2018.07.026
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发表时间：
2018-09-01
影响因子：
3.3
通讯作者：
Pinker, Katja
中科院分区：
文献类型：
--
作者：
Marino, Maria Adele;Riedl, Christopher C.;Pinker, Katja
目的：利用第五版BI-RADS评估家族性乳腺癌在乳房x线摄影（MG）、超声（US）和磁共振成像（MRI）上的成像表型；为了调查观察者之间的一致性，并将成像表型与风险状态、组织病理学和免疫组织化学替代物衍生的分子亚型相关联。材料和方法：49名女性（BRCA-1/2突变携带者和终身风险为20%的女性）在我们的高风险筛查项目中被诊断为乳腺癌。BI-RADS MG、US和MRI成像描述符与风险状态、组织病理学和免疫组织化学替代物衍生的分子亚型相关。评估BI-RADS MG、US和MRI分类的评分间一致性。结果：52例乳腺癌被诊断出来，98%至少在一种模式下可检测到。MRI检出更多的肿瘤（P < 0.001）。BI-RADS无良性病变。BRCA-1在后、上外象限有三阴性、高级别肿瘤（P < 0.01）；阳性家族史患者在中间部分（P = 0.04）和外上象限（P = 0.05）有中度肿瘤（P < 0.01）。MG （k = 0.554）和MRI （k = 0.512）指定的BI-RADS评估的评分间一致性中等，US （k = 0.741）的评分间一致性较大。结论：具有BI-RADS的家族性乳腺癌的影像学表型在所有影像学方式下都是恶性的。风险状况似乎影响癌症的位置。
Objective: To assess imaging phenotypes of familial breast cancer on mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) using the fifth edition of the BI-RADS; to investigate inter-observer agreement and to correlate imaging phenotypes with risk status, histopathology, and molecular subtypes derived by immunohistochemical surrogate.Materials and Methods: Forty-nine women (BRCA-1/2 mutation carriers and women with > 20% lifetime risk) were diagnosed with breast cancer within our high-risk screening program. BI-RADS MG, US, and MRI imaging descriptors were correlated with risk status, histopathology, and molecular subtypes derived by immunohistochemical surrogate. Inter-rater agreement for BI-RADS MG, US, and MRI categories was assessed.Results: Fifty-two breast cancers were diagnosed and 98% were detectable in at least one modality. MRI detected more cancers (P < 0.001). No lesion had benign morphology on BI-RADS. BRCA-1 had triple-negative and high-grade tumors in the posterior part and in the upper-outer quadrant (P < 0.01); positive-family-history patients had intermediate-grade neoplasms (P < 0.01) in the middle part (P = 0.04) and in the upper-outer quadrants (P = 0.05). There was moderate inter-rater agreement for the assigned BI-RADS assessment for MG (k = 0.554) and MRI (k = 0.512) and substantial inter-rater agreement for US (k = 0.741).Conclusions: Imaging phenotypes of familial breast cancers with BI-RADS are malignant in all imaging modalities. Risk status seems to influence cancer location.