Does background parenchymal enhancement on MRI affect the rate of positive resection margin in breast cancer patients?
Does background parenchymal enhancement on MRI affect the rate of positive resection margin in breast cancer patients?
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DOI：
10.1259/bjr.20140638
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发表时间：
2015-02-01
影响因子：
2.6
通讯作者：
Kim, T. H.
中科院分区：
文献类型：
--
作者：
Park, S. Y.;Kang, D. K.;Kim, T. H.
目的：本研究的目的是评估是否强背景实质增强（BPE）将是一个显着的独立因素，与积极的切除边缘的患者接受了保乳手术（BCS）。方法：回顾性评价314例乳腺癌患者的乳腺MRI检查。2008年1月至2010年12月接受BCS的所有患者均经组织学确诊为乳腺癌。将BPE分为弱（轻微或轻度）和强（中度或显著）增强进行统计分析。结果：单因素分析显示，广泛导管内成分阳性（p < 0.001）、BPE强阳性（p= 0.001）和人表皮生长因子受体2（HER 2）阳性（p=0.08）与切缘阳性有显著相关性。肿瘤大小、腋窝淋巴结转移、核分级、组织学分级、淋巴管浸润、雌激素受体和孕激素受体与手术切缘阳性无明显相关性。在多变量分析中，重要的独立预测因素是广泛的导管内成分[比值比，5.68; 95%置信区间（CI），2.72-11.82]和强BPE（比值比，2.39; 95%CI，1.20-4.78）。强BPE是切缘阳性沿着伴阳性广泛导管内成分的重要独立因素，结论：BPE是一个与切缘阳性相关的重要独立因素，对BPE较强的患者应在低实质强化期行MRI检查。
Objective: The purpose of our study was to evaluate whether strong background parenchymal enhancement (BPE) would be a significant independent factor associated with positive resection margin in patients treated initially with breast-conserving surgery (BCS).Methods: Retrospective evaluation of breast MRI examinations of 314 patients with breast cancer was carried out. Breast cancer was histologically confirmed in all patients who underwent BCS from January 2008 to December 2010. BPE was dichotomized into weak (minimal or mild) and strong (moderate or marked) enhancement for statistical analysis. Histopathological features of attained specimens were evaluated by an experienced pathologist and were also dichotomized for statistical analysis.Results: On univariate analysis, positive extensive intraductal component (p < 0.001), strong BPE (p=0.001) and human epidermal growth factor receptor 2 (HER2) positivity (p=0.08) had significant association with positive surgical margin. Tumour size, axillary lymph node metastasis, nuclear grade, histological grade, lymphovascular invasion, oestrogen receptor and progesterone receptor did not show significant correlation with positive surgical margin. On multivariate analysis, the significant independent predictors were extensive intraductal component [odds ratio, 5.68; 95% confidence interval (CI), 2.72-11.82] and strong BPE (odds ratio, 2.39; 95% CI, 1.20-4.78).Conclusion: Strong BPE is a significant independent factor for positive resection margin along with positive extensive intraductal component, and performing MRI during the period of lower parenchymal enhancement is needed in patients with strong BPE.Advances in knowledge: As far as we know, this is the first study to reveal that BPE is a significant independent factor associated with positive resection margin.