Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Breast Cancer in Women Younger than 35-Years-Old: Correlation of MRI Findings with Clinicopathological Features and Immunohistochemical Subtypes

35세 이하 젊은 여성의 유방암: 자기공명영상 소견과 임상병리학적 및 면역조직화학 특성과의 상관관계

  • Lee, Sae Hyung (Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic Unversity of Korea) ;
  • Kang, Bong Joo (Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • An, Yeong Yi (Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic Unversity of Korea)
  • 이세형 (가톨릭대학교 의과대학 성빈센트병원 영상의학과) ;
  • 강봉주 (가톨릭대학교 의과대학 서울성모병원 영상의학과) ;
  • 안영이 (가톨릭대학교 의과대학 성빈센트병원 영상의학과)
  • Received : 2018.02.23
  • Accepted : 2018.06.13
  • Published : 2018.10.01
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Abstract

Purpose: Breast cancer of young women shows poor prognosis, but the imaging findings has not been well known. We evaluated the MRI characteristics of young women. Materials and Methods: From January 2009 to December 2013, we included 91 patients under the age of 35 who were diagnosed histologically as breast cancer and underwent MRI. The relationship between the clinical and histopathological prognostic factors was obtained using electronic medical records and the retrospective analysis of MRI findings was statistically analyzed. Results: The most common imaging findings of breast mass were irregular shape (53.7%), irregular margin (53.7%), heterogeneous enhancement (53.8%), and type 3 kinetic curve pattern (57.1%). In the multivariate analysis, the rim enhancement was significantly related to the higher tissue grade (p = 0.001), estrogen receptor negative (p < 0.001), and progesterone receptor negative (p < 0.001). The irregular mass shape (p = 0.015) and type 3 kinetic curve (p = 0.002) were related to lymph node metastasis. Conclusion: MRI findings of breast cancer in young women (${\leq}35-years-old$) are not different from those of general breast cancer, but the rim enhancement, irregular mass shape and type 3 kinetic curve are related with pathologic factors of poor prognosis.

목적: 35세 이하 젊은 유방암 환자의 자기공명영상 소견을 알아보고 조직 병리학적 예후 인자와의 상관관계를 알아보고자 하였다. 대상과 방법: 2009년 1월부터 2013년 12월까지 본원에서 조직학적으로 유방암이 확진된 35세 이하 환자 중 유방 자기공명영상 촬영을 시행한 91명을 대상으로 하였다. 전자의무기록을 이용해 얻어진 임상 및 조직병리학적 예후 인자와 후향적으로 분석된 자기공명영상 판독 소견과의 관계를 통계적으로 비교 분석하였다. 결과: 가장 흔한 자기공명영상 소견은 종괴의 불규칙한 모양(53.7%), 불규칙한 경계(53.7%), 비균질한 조영증강(53.8%), Type 3 조영증강 패턴(57.1%)이었다. 다변량 분석에서 종괴의 테두리 조영증강이 높은 조직 등급(p = 0.001), 에스트로겐 수용체 음성(p < 0.001), 프로게스테론 수용체 음성(p < 0.001)과 통계적으로 유의한 관련이 있었다. 또한, 불규칙한 종괴의 모양(p = 0.015)과 Type 3 조영증강 패턴(p = 0.002)은 임파선 전이와 통계적으로 유의한 관련이 있었다. 결론: 35세 이하의 젊은 여성에서 생긴 유방암의 자기공명영상 소견은 일반적인 유방암의 소견과 다르지 않지만, 자기공명영상에서 종괴의 테두리 조영증강, 불규칙한 종괴 모양 그리고 Type 3 조영증강 패턴은 나쁜 예후의 병리학적 인자들과 관련이 있다.

Keywords

References

  1. Jemal A, Clegg LX, Ward E, Ries LA, Wu X, Jamison PM, et al. Annual report to the naion on the status of cancer, 1975-2001, with a special feature regarding survival. Cancer 2004; 101:3-27
  2. Han W, Kim SW, Park IA, Kang D, Kim SW, Youn YK, et al. Young age: an independent risk factor for disease-free survival in women with operable breast cancer. BMC Cancer 2004;4:82
  3. Yoo KY, Park SK, Sung J, Kang D, Kim YC, Kang HS, et al. [High risk groups for female breast cancer in Korea]. J Korean Cancer Assoc 1998;30:435-449
  4. Korea Central Cancer Registry, 2002 Annual Report of the Korea, Seoul: Korea Central Cancer Registry 2003
  5. Ko SS, Korean Breast Cancer Society. Chronological changing patterns of clinical characteristics of Korean breast cancer patients during 10 years (1996-2006) using nationwide breast cancer registration on-line program: biannual update. J Surg Oncol 2008;98:318-323
  6. Gabriel CA, Domchek SM. Breast cancer in young women. Breast Cancer Res 2010;12:212
  7. Klauber-DeMore N. Tumor biology of breast cancer in young women. Breast Dis 2006;23:9-15
  8. American College of Radiology. Breast Imaging and Reporting and Data System (ACR BI-$RADS^{(R)}$ Atlas). Reston, VA: American College of Radiology, 2013
  9. Korea Central Cancer Registry, 2014 Annual Report of the Korea, Seoul: Korea Central Cancer Registry 2014
  10. An YY, Kim SH, Kang BJ. Characteristic features and usefulness of MRI in breast cancer in patients under 40 years old: correlations with conventional imaging and prognostic factors. Breast Cancer 2014;21:302-315
  11. Kim J, Jang M, Kim SM, Yun BL, Lee JY, Kim EK, et al. Clinicopathological and imaging features of breast cancer in Korean women under 40 years of age. J Korean Soc Radiol 2017;76:375-385
  12. Kim JY, Lee SH, Lee JW, Kim S, Choo KS. Magnetic resonance imaging characteristics of invasive breast cancer in women aged less than 35 years. Acta Radiol 2015;56:924-932
  13. Collins LC, Marotti JD, Gelber S, Cole K, Ruddy K, Kereakoglow S, et al. Pathologic features and molecular phenotype by patient age in a large cohort of young women with breast cancer. Breast Cancer Res Treat 2012;131:1061-1066
  14. Kim EK, Noh WC, Han W, Noh DY. Prognostic significance of young age ( < 35 years) by subtype based on ER, PR, and HER2 status in breast cancer: a nationwide registry-based study. World J Surg 2011;35:1244-1253
  15. Morrison DH, Rahardja D, King E, Peng Y, Sarode VR. Tumour biomarker expression relative to age and molecular subtypes of invasive breast cancer. Br J Cancer 2012;107:382-387
  16. Cancello G, Maisonneuve P, Rotmensz N, Viale G, Mastropasqua MG, Pruneri G, et al. Prognosis and adjuvant treatment effects in selected breast cancer subtypes of very young women (< 35 years) with operable breast cancer. Ann Oncol 2010;21:1974-1981
  17. Cancello G, Maisonneuve P, Mazza M, Montagna E, Rotmensz N, Viale G, et al. Pathological features and survival outcomes of very young patients with early breast cancer: how much is "very young"? Breast 2013;22:1046-1051
  18. Lin CH, Liau JY, Lu YS, Huang CS, Lee WC, Kuo KT, et al. Molecular subtypes of breast cancer emerging in young women in Taiwan: evidence for more than just westernization as a reason for the disease in Asia. Cancer Epidemiol Biomarkers Prev 2009;18:1807-1814
  19. Putti TC, El-Rehim DM, Rakha EA, Paish CE, Lee AH, Pinder SE, et al. Estrogen receptor-negative breast carcinomas: a review of morphology and immunophenotypical analysis. Mod Pathol 2005;18:26-35
  20. Jinguji M, Kajiya Y, Kamimura K, Nakajo M, Sagara Y, Takahama T, et al. Rim enhancement of breast cancers on contrast-enhanced MR imaging: relationship with prognostic factors. Breast Cancer 2006;13:64-73
  21. Szabo BK, Aspelin P, Kristoffersen Wiberg M, Tot T, Bone B. Invasive breast cancer: correlation of dynamic MR features with prognostic factors. Eur Radiol 2003;13:2425-2435
  22. Teifke A, Behr O, Schmidt M, Victor A, Vomweg TW, Thelen M, et al. Dynamic MR imaging of breast lesions: correlation with microvessel distribution pattern and histologic characteristics of prognosis. Radiology 2006;239:351-360
  23. Jatoi I, Hilsenbeck SG, Clark GM, Osborne CK. Significance of axillary lymph node metastasis in primary breast cancer. J Clin Oncol 1999;17:2334-2340
  24. Giardina C, Ricco R, Lettini T, Gentile A, Serio G, De Benedictis G, et al. Relation between primary tumor shape and biological behavior in breast cancer. Tumori 1989;75:117-122
  25. Guo Q, Dong Z, Zhang L, Ning C, Li Z, Wang D, et al. Ultrasound features of breast cancer for predicting axillary lymph node metastasis. J Ultrasound Med 2018;37:1353-1354
  26. Bahri S, Chen JH, Yu HJ, Kuzucan A, Nalcioglu O, Su MY. Can dynamic contrast-enhanced MRI (DCE-MRI) predict tumor recurrence and lymph node status in patients with breast cancer? Ann Oncol 2008;19:822-824
  27. Loiselle CR, Eby PR, DeMartini WB, Peacock S, Bittner N, Lehman CD, et al. Dynamic contrast-enhanced MRI kinetics of invasive breast cancer: a potential prognostic marker for radiation therapy. Int J Radiat Oncol Biol Phys 2010;76:1314-1319

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