MRI Features for Prediction Malignant Intra-Mammary Lymph Nodes: Correlations with Mammography and Ultrasound
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Purpose: To assess clinically significant imaging findings of malignant intramammary lymph nodes (IMLNs) in breast cancer patients and to evaluate their diagnostic performance in predicting malignant IMLN. Materials and Methods: A total of 110 cases with IMLN of BI-RADS category 3 or more, not typical benign IMLN, in MR of breast cancer patients between January 2016 and January 2021 were retrospectively reviewed. After excluding 33 cases, 77 cases were finally included. Among them, 58 and 19 were confirmed as benign and malignant, respectively. Qualitative and quantitative MR imaging features of the IMLN were retrospectively analyzed. Sizes and final assessment categories of IMLN on MRI, mammography, and ultrasound were reviewed. Diagnostic performances of imaging features on MRI, mammography, and ultrasound were then evaluated. Results: For qualitative MR features, shape, margin, and preserved central hilum were significantly different between benign and malignant groups (P < 0.05). For quantitative MR features, long diameter over 6 mm, short diameter over 4 mm, and cortical thickening over 3 mm showed high sensitivities in predicting malignant IMLNs (89.5%, 94.7%, and 100%, respectively). Size exceeding 1 cm showed high specificity and accuracy in predicting malignant IMLN on MR, mammography, and ultrasound (91.4% and 80.5%; 96.6% and 79.25; 98.3% and 80.5%, respectively). Conclusion: Various MR imaging features and size can be helpful for predicting malignant IMLN in breast cancer patients.
Abstract
Purpose: To assess clinically significant imaging findings of malignant intramammary lymph nodes (IMLNs) in breast cancer patients and to evaluate their diagnostic performance in predicting malignant IMLN. Materials and Methods: A total of 110 cases with IMLN of BI-RADS category 3 or more, not typical benign IMLN, in MR of breast cancer patients between January 2016 and January 2021 were retrospectively reviewed. After excluding 33 cases, 77 cases were finally included. Among them, 58 and 19 were confirmed as benign and malignant, respectively. Qualitative and quantitative MR imaging features of the IMLN were retrospectively analyzed. Sizes and final assessment categories of IMLN on MRI, mammography, and ultrasound were reviewed. Diagnostic performances of imaging features on MRI, mammography, and ultrasound were then evaluated. Results: For qualitative MR features, shape, margin, and preserved central hilum were significantly different between benign and malignant groups (P < 0.05). For quantitative MR features, long diameter over 6 mm, short diameter over 4 mm, and cortical thickening over 3 mm showed high sensitivities in predicting malignant IMLNs (89.5%, 94.7%, and 100%, respectively). Size exceeding 1 cm showed high specificity and accuracy in predicting malignant IMLN on MR, mammography, and ultrasound (91.4% and 80.5%; 96.6% and 79.25; 98.3% and 80.5%, respectively). Conclusion: Various MR imaging features and size can be helpful for predicting malignant IMLN in breast cancer patients.
참고문헌 (22)
- Chang JM, "Axillary nodal evaluation in breast cancer : state of the art", Radiology, 295, pp.500~515 (2020)
- Kim SH, "Diagnostic performance of fused diffusion-weighted imaging using T1-weighted imaging for axillary nodal staging in patients with early breast cancer", Clin Breast Cancer, 17, pp.154~163 (2017)
- Kim EJ, "Diagnostic value of breast MRI for predicting metastatic axillary lymph nodes in breast cancer patients : diffusionweighted MRI and conventional MRI", Magn Reson Imaging, 32, pp.1230~1236 (2014)
- Shen J, "Intramammary lymph node metastases are an independent predictor of poor outcome in patients with breast carcinoma", Cancer, 101, pp.1330~1337 (2004)
- Hogan BV, "Intramammary lymph node metastasis predicts poorer survival in breast cancer patients", Surg Oncol, 19, pp.11~16 (2010)
- Abdullgaffar B, "The significance of intramammary lymph nodes in breast cancer : a systematic review and meta-analysis", Int J Surg Pathol, 20, pp.555~563 (2012)
- Hashem T, "Intramammary lymph nodes, an overlooked breast cancer prognostic tool?", World J Surg Oncol, 19, pp.114~ (2021)
- Bitencourt AG, "Intramammary lymph nodes : normal and abnormal multimodality imaging features", Br J Radiol, 92, pp.20190517~ (2019)
- Guth AA, "Intramammary lymph nodes and breast cancer: a marker for disease severity, or just another lymph node?", Am J Surg, 192, pp.502~505 (2006)
- Lee SK, "The clinical meaning of intramammary lymph nodes", Oncology, 84, pp.1~5 (2013)
- Zhao Bi, "Internal Mammary Sentinel Lymph Node Biopsy after Neoadjuvant Chemotherapy in Breast Cancer", Journal of Breast Cancer, 21(4), pp.442~446 (2018), 한국유방암학회[DOI]
- Kim R, "Predicting axillary response to neoadjuvant chemotherapy : breast MRI and US in patients with node-positive breast cancer", Radiology, 293, pp.49~57 (2019)
- 정예슬, "Analysis of the molecular subtypes of preoperative core needle biopsy and surgical specimens in invasive breast cancer", Journal of Pathology and Translational Medicine, 54(1), pp.87~94 (2020), 대한병리학회[DOI]
- Goldhirsch A, "Personalizing the treatment of women with early breast cancer : highlights of the St Gallen International Expert Consensus on the Primary Therapy of Early Breast Cancer 2013", Ann Oncol, 24, pp.2206~2223 (2013)
- Gunhan-Bilgen I, "Metastatic intramammary lymph nodes : mammographic and ultrasonographic features", Eur J Radiol, 40, pp.24~29 (2001)
- Edeiken-Monroe BS, "Metastases to intramammary lymph nodes in patients with breast cancer : sonographic findings", J Clin Ultrasound, 36, pp.279~285 (2008)
- Ecanow JS, "Axillary staging of breast cancer : what the radiologist should know", Radiographics, 33, pp.1589~1612 (2013)
- Baltzer PA, "Application of MR mammography beyond local staging : is there a potential to accurately assess axillary lymph nodes? Evaluation of an extended protocol in an initial prospective study", AJR Am J Roentgenol, 196, pp.W641~647 (2011)
- Jellici E, "Focal breast lesions with benign appearances. Review of eight breast cancers with initial features of intramammary lymph node", Radiol Med, 111, pp.1078~1086 (2006)
- Harnan SE, "Magnetic resonance for assessment of axillary lymph node status in early breast cancer : a systematic review and meta-analysis", Eur J Surg Oncol, 37, pp.928~936 (2011)
- Zhao M, "Magnetic resonance imaging features for predicting axillary lymph node metastasis in patients with breast cancer", Eur J Radiol, 129, pp.109093~ (2020)
- Dietzel M, "Application of breast MRI for prediction of lymph node metastases-systematic approach using 17 individual descriptors and a dedicated decision tree", Acta Radiol, 51, pp.885~894 (2010)