Investigative Magnetic Resonance Imaging

Korean Society of Magnetic Resonance in Medicine (대한자기공명의과학회)
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MRI Findings of Triple Negative Breast Cancer: A Comparison with Non-Triple Negative Breast Cancer

삼중음성 유방암의 자기공명영상 소견: 비삼중음성 유방암과의 비교

  • Choi, Jae-Jeong (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kim, Sung-Hun (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Cha, Eun-Suk (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Kang, Bong-Joo (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Lee, Ji-Hye (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Lee, So-Yeon (Department of Radiology, College of Medicine, The Catholic University of Korea) ;
  • Jeong, Seung-Hee (Clinical Research Coordinating Center, College of Medicine, The Catholic Medical Center) ;
  • Yim, Hyeon-Woo (Clinical Research Coordinating Center, College of Medicine, The Catholic Medical Center) ;
  • Song, Byung-Joo (Department of Surgery, College of Medicine, The Catholic University of Korea)
  • 최재정 (가톨릭대학교 의과대학 영상의학과) ;
  • 김성헌 (가톨릭대학교 의과대학 영상의학과) ;
  • 차은숙 (가톨릭대학교 의과대학 영상의학과) ;
  • 강봉주 (가톨릭대학교 의과대학 영상의학과) ;
  • 이지혜 (가톨릭대학교 의과대학 영상의학과) ;
  • 이소연 (가톨릭대학교 의과대학 영상의학과) ;
  • 정승희 (가톨릭대학교 의과대학 임상연구 지원센터) ;
  • 임현우 (가톨릭대학교 의과대학 임상연구 지원센터) ;
  • 송병주 (가톨릭대학교 의과대학 외과)
  • Received : 2010.09.27
  • Accepted : 2010.12.01
  • Published : 2010.12.30
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Abstract

Purpose : To evaluate the magnetic resonance imaging (MRI) and clinicopathological features of triple negative breast cancer, and compare them with those of non-triple negative breast cancer. Materials and Methods : This study included 231 pathologically confirmed breast cancers from January 2007 to May 2008. We retrospectively reviewed the MRI findings according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon: mass or non-mass type, mass shape, mass margin, non-mass distribution, and enhancement pattern. Histologic type, histologic grade, and the results for epidermal growth factor receptor, p53, and Ki 67 were reviewed. Results : Of 231 patients, 43(18.6%) were triple negative breast cancer. Forty triple negative breast cancers (93.0%) were mass-type lesion on MRI. A round or oval or lobular shape (p=0.006) and rim enhancement (p=0.004) were significantly more in triple negative breast cancer than non- triple negative breast cancer. In contrast, irregular shape (p=0.006) and spiculated margins (p=0.032) were significantly more in non-triple negative breast cancer. Old age (p=0.019), high histologic grade (p<0.0001), EGFR positivity (p<0.0001), p53 overexpression (p=0.038), and Ki 67 expression (<0.0001) were significantly associated with the triple negative breast cancer. Conclusion : MRI finding may be helpful for differentiation between triple negative and non-triple negative breast cancer.

목적 : 삼중음성 유방암은 국소재발 및 원격전이가 흔하고 예후가 불량한 유방암이다. 이의 자기공명영상 소견과 임상적, 병리학적 소견이 비삼중음성 유방암과 차이가 있는지 알아보고자 한다. 대상 및 방법 : 2007년부터 2008년까지 수술로 확진된 231명의 유방암 환자를 대상으로 하였다. 자기공명영상 소견에서 대표 병변을 Breast Imaging Reporting and Data System (BI-RADS)에 따라 후향적으로 분석하였고 삼중음성 유방암의 소견이 비삼중음성 유방암과 차이가 있는지 알아보았다. 또한 나이, 조직학적 형태, 분화도, 표피 성장인자 수용체, p53, Ki 67의 발현 정도가 두 군간에 차이가 있는지 분석하였다. 결과 : 총 231명 중 43명 (18.6%)이 삼중음성 유방암이었다. 삼중음성 유방암 중 40개 (93%)가 자기공명영상에 서 종괴병변 이었다. 삼중음성 유방암은 비삼중음성 유방암에 비해 원형, 난원형 또는 소엽성 모양 (p=0.006), 변연 조영증강 (p=0.004) 소견이 많았다. 반면 불규칙 모양(p=0.006)과 침상경계(p=0.032)는 비삼중음성 유방암에 유의하게 많았다. 고령 (p=0.019), 높은 조직 분화도 (p < 0.0001), 표피성장인자 수용체 양성(p < 0.0001), p53 (p=0.038)과 Ki 67 (< 0.0001) 과발현이 삼중음성 유방암과 관련이 있었다. 결론 : 자기공명영상 소견은 삼중음성 유방암과 비삼중음성 유방암을 구분하는데 도움이 된다.

Keywords

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