Invasive Breast Cancer: Prognostic Value of Peritumoral Edema Identified at Preoperative MR Imaging
Invasive Breast Cancer: Prognostic Value of Peritumoral Edema Identified at Preoperative MR Imaging
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DOI：
10.1148/radiol.2017171157
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发表时间：
2018-04-01
期刊：
影响因子：
19.7
通讯作者：
Kim, Won Hwa
中科院分区：
文献类型：
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作者：
Cheon, Hyejin;Kim, Hye Jung;Kim, Won Hwa
目的：为了确定术前乳腺磁共振（MR）成像确定的瘤周水肿对浸润性乳腺癌患者疾病复发的预后价值。材料和方法：2011年1月至2012年12月，353名女性（中位年龄49岁;范围，27-77岁），浸润性乳腺癌谁经历了术前MR成像和乳房切除术或保乳手术。两名放射科医生根据T2加权像上肿瘤周围的信号强度独立审查瘤周水肿。使用多变量考克斯比例风险模型和综合判别改善（IDI）和连续净重新分类改善（NRI）index.Results：24例（6.8%）患者（中位随访27.2个月后）疾病复发与瘤周水肿和临床病理特征的关联进行了评估。在多变量分析中，较高的N分期（风险比= 4.84，P = 0.002）、淋巴血管浸润（风险比= 2.48，P = 0.044）和瘤周水肿（风险比= 2.77，P = 0.022）是与疾病复发相关的独立因素。当瘤周水肿添加到已确定的临床病理特征中时，IDI和连续NRI显示与疾病复发相关性的准确性显着提高（IDI = 0.061，P
Purpose: To determine the prognostic value of peritumoral edema identified at preoperative breast magnetic resonance (MR) imaging for disease recurrence in patients with invasive breast cancer.Materials and Methods: Between January 2011 and December 2012, 353 women (median age, 49 years; range, 27-77 years) with invasive breast cancer who had undergone preoperative MR imaging and mastectomy or breast-conserving surgery were identified. Two radiologists independently reviewed peritumoral edema on the basis of the degree of the signal intensity surrounding the tumor on T2-weighted images. The association of disease recurrence with peritumoral edema and clinical-pathologic features was assessed by using the multivariate Cox proportional hazards model and the integrated discrimination improvement (IDI) and continuous net reclassification improvement (NRI) indexes.Results: Twenty-four patients (6.8%) had disease recurrence after 27.2 months of median follow-up. At multivariate analysis, higher N stage (hazard ratio = 4.84, P =.002) and the presence of lymphovascular invasion (hazard ratio = 2.48, P =.044) and peritumoral edema (hazard ratio = 2.77, P =.022) were independent factors associated with disease recurrence. IDI and continuous NRI showed significant improvement in the accuracy of the association with disease recurrence when peritumoral edema was added to established clinical-pathologic features (IDI = 0.061, P