MRI Background Parenchymal Enhancement as a Risk Factor for Breast Cancer

MRI 背景实质增强是乳腺癌的危险因素

• 批准号: 8776507
• 负责人: JONINE L. BERNSTEIN
• 金额: $ 71.59万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8776507
• 关键词: Age; American College of Radiology; Area; Blinded; Breast; Breast Cancer Detection; Breast Cancer Risk Factor; Cancer Patient; Case-Control Studies; Categories; Characteristics; Classification; Clinical; Clinical Data; Clinical Management; Clinical Research; Computerized Medical Record; Computers; Contrast Media; Diagnosis; Epidemiology; Ethnic Origin; Goals; High Risk Woman; Hospitals; Image; Information Systems; Interview; Joints; Magnetic Resonance Imaging; Malignant Neoplasms; Mammary Gland Parenchyma; Mammographic Density; Mammography; Measures; Medical Records; Memorial Sloan-Kettering Cancer Center; Menopausal Status; Methods; Modeling; Outcome; Participant; Patients; Phase; Preventive Intervention; Preventive screening; Quality Control; Questionnaires; Race; Reader; Recruitment Activity; Reporting; Research; Risk; Risk Assessment; Risk Estimate; Risk Factors; Running; Staging; Subgroup; Telephone Interviews; Time; Tissues; Woman; abstracting; base; cancer risk; computerized; density; follow-up; high risk; improved; malignant breast neoplasm; novel; public health relevance; screening; tool; tumor

DESCRIPTION (provided by applicant): Contrast-enhanced breast magnetic resonance imaging (MRI) is a clinically useful tool for breast cancer screening in high-risk women and the diagnosis, staging, and clinical management of breast cancer patients, and may also have utility in the determination of breast cancer risk. Normal breast fibroglandular tissue (FGT), which appears white on mammography (i.e. mammographic density (MD)), is a well-established risk factor for breast cancer. FGT is also visible on breast MRI (MRI-FGT) and enhances (becomes brighter) to varying extents after administration of MRI-contrast medium. Background parenchymal enhancement (MRI-BPE) is a measure of the volume and intensity of this enhancement. In a study of 39 breast cancer cases and 78 cancer- free controls undergoing breast screening with MRI, MRI-BPE was strongly associated with breast cancer risk; women in the highest MRI-BPE category had a 7.5-fold higher risk of breast cancer compared with those in the lowest MRI-BPE groups. MRI-BPE only weakly correlated with MRI-FGT, which is strongly correlated with MD, indicating that MRI-BPE may be an independent marker of breast cancer risk. We propose to confirm these findings by conducting a multi-center, hospital-based, case-control study examining MRI-BPE and MRI-FGT as markers of breast cancer risk. Across three centers we will recruit, interview, and collect medical records and pre-treatment MRIs and mammograms from 1,110 women with invasive breast cancer (cases) and 1,110 high- risk women who are cancer-free and are undergoing MRI breast cancer screening (controls). Clinical data and tumor characteristics (for cases) will be abstracted through electronic medical record review. MRI-BPE and MRI-FGT will be scored by a single reader using standard clinical measures and mammographic percent density (MPD) using Cumulus. We also propose to measure both MRI-BPE and MRI-FGT using a new fully automated method. Our hypothesis is that while MRI-FGT and MPD measure the amount of FGT, MRI-BPE is a marker of breast tissue activity, contributing to breast cancer risk independently of the amount of FGT present. Our Primary Aim is to examine the relationship between MRI-BPE and MRI-FGT measured by Breast Imaging-Reporting and Data System (BI-RADS) categories, and breast cancer risk. Our Secondary Aims are: 1) to determine whether the inclusion of MRI-BPE improves breast cancer risk assessment over that achieved by MPD alone; and 2) to examine the association between MRI-BPE and MRI-FGT, measured on a continuous scale by a novel automated computerized method, and breast cancer risk. In the long-run MRI-BPE could greatly improve the accuracy of breast cancer risk prediction among high-risk women undergoing breast MRI screening by identifying a subgroup of women who would benefit the most from heightened screening and preventive measures and possibly a subgroup of women at lower risk who may benefit from less intensive screening. The automated quantitative measures of MRI-BPE and MRI-FGT would greatly facilitate the incorporation of these measures into widespread clinical and research practice.

描述（由申请人提供）：对比增强乳腺磁共振成像（MRI）是一种用于高危女性乳腺癌筛查以及乳腺癌患者诊断、分期和临床管理的临床有用工具，也可用于确定乳腺癌风险。正常乳腺纤维腺体组织（FGT）在乳房X线摄影（即乳房X线摄影密度（MD））上显示为白色，是乳腺癌的一个公认风险因素。FGT在乳腺MRI（MRI-FGT）上也可见，并在给予MRI造影剂后不同程度地增强（变得更亮）。背景实质增强（MRI-BPE）是这种增强的体积和强度的量度。在一项对39例乳腺癌病例和78例接受MRI乳腺筛查的无癌对照的研究中，MRI-BPE与乳腺癌风险密切相关;与最低MRI-BPE组相比，最高MRI-BPE组的女性患乳腺癌的风险高7.5倍。MRI-BPE仅与MRI-FGT弱相关，而MRI-FGT与MD强相关，表明MRI-BPE可能是乳腺癌风险的独立标志物。我们建议通过进行一项多中心、以医院为基础的病例对照研究来证实这些发现，该研究将MRI-BPE和MRI-FGT作为乳腺癌风险的标志物。在三个中心，我们将招募、采访和收集1，110名浸润性乳腺癌女性（病例）和1，110名无癌症且正在接受MRI乳腺癌筛查的高危女性（对照组）的医疗记录和治疗前MRI和乳房X线照片。将通过电子病历审查提取临床数据和肿瘤特征（对于病例）。MRI-BPE和MRI-FGT将由一名阅片人使用标准临床指标进行评分，并使用Cumulus进行乳腺摄影百分比密度（MPD）。我们还建议使用一种新的全自动方法测量MRI-BPE和MRI-FGT。我们的假设是，虽然MRI-FGT和MPD测量FGT的量，但MRI-BPE是乳腺组织活性的标志物，与FGT的量无关地增加乳腺癌的风险。我们的主要目的是检查乳腺成像报告和数据系统（BI-RADS）类别测量的MRI-BPE和MRI-FGT与乳腺癌风险之间的关系。我们的次要目标是：1）确定与单独使用MPD相比，纳入MRI-BPE是否可以改善乳腺癌风险评估;和2）检查MRI-BPE和MRI-FGT之间的关联（通过新型自动化计算机化方法连续测量）和乳腺癌风险。从长远来看，MRI-BPE可以大大提高接受乳腺MRI筛查的高风险女性中乳腺癌风险预测的准确性，方法是确定一个从加强筛查和预防措施中获益最多的女性亚组，以及一个可能从不太密集的筛查中获益的低风险女性亚组。MRI-BPE和MRI-FGT的自动定量测量将极大地促进将这些测量纳入广泛的临床和研究实践。