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Can breast cancer molecular subtype help to select patients for preoperative MR imaging?

Publication ,  Journal Article
Grimm, LJ; Johnson, KS; Marcom, PK; Baker, JA; Soo, MS
Published in: Radiology
February 2015

PURPOSE: To assess whether breast cancer molecular subtype classified by surrogate markers can be used to predict the extent of clinically relevant disease with preoperative breast magnetic resonance (MR) imaging. MATERIALS AND METHODS: In this HIPAA-compliant, institutional review board-approved study, informed consent was waived. Preoperative breast MR imaging reports from 441 patients were reviewed for multicentric and/or multifocal disease, lymph node involvement, skin and/or nipple invasion, chest wall and/or pectoralis muscle invasion, or contralateral disease. Pathologic reports were reviewed to confirm the MR imaging findings and for hormone receptors (estrogen and progesterone subtypes), human epidermal growth factor receptor type 2 (HER2 subtype), tumor size, and tumor grade. Surrogates were used to categorize tumors by molecular subtype: hormone receptor positive and HER2 negative (luminal A subtype); hormone receptor positive and HER2 positive (luminal B subtype); hormone receptor negative and HER2 positive (HER2 subtype); hormone receptor negative and HER2 negative (basal subtype). All patients included in the study had a histologic correlation with MR imaging findings or they were excluded. χ(2) analysis was used to compare differences between subtypes, with multivariate logistic regression analysis used to assess for variable independence. RESULTS: Identified were 289 (65.5%) luminal A, 45 (10.2%) luminal B, 26 (5.9%) HER2, and 81 (18.4%) basal subtypes. Among subtypes, significant differences were found in the frequency of multicentric and/or multifocal disease (luminal A, 27.3% [79 of 289]; luminal B, 53.3% [24 of 45]; HER2, 65.4% [17 of 26]; basal, 27.2% [22 of 81]; P < .001) and lymph node involvement (luminal A, 17.3% [50 of 289]; luminal B, 35.6% [26 of 45]; HER2, 34.6% [nine of 26]; basal 24.7% [20 of 81]; P = .014). Multivariate analysis showed that molecular subtype was independently predictive of multifocal and/or multicentric disease. CONCLUSION: Preoperative breast MR imaging is significantly more likely to help detect multifocal and/or multicentric disease and lymph node involvement in luminal B and HER2 molecular subtype breast cancers. Molecular subtype may help to select patients for preoperative breast MR imaging.

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Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

February 2015

Volume

274

Issue

2

Start / End Page

352 / 358

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Receptor, erbB-2
  • Receptor, ErbB-2
  • Preoperative Care
  • Patient Selection
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Magnetic Resonance Imaging
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Grimm, L. J., Johnson, K. S., Marcom, P. K., Baker, J. A., & Soo, M. S. (2015). Can breast cancer molecular subtype help to select patients for preoperative MR imaging? Radiology, 274(2), 352–358. https://doi.org/10.1148/radiol.14140594
Grimm, Lars J., Karen S. Johnson, P Kelly Marcom, Jay A. Baker, and Mary S. Soo. “Can breast cancer molecular subtype help to select patients for preoperative MR imaging?Radiology 274, no. 2 (February 2015): 352–58. https://doi.org/10.1148/radiol.14140594.
Grimm LJ, Johnson KS, Marcom PK, Baker JA, Soo MS. Can breast cancer molecular subtype help to select patients for preoperative MR imaging? Radiology. 2015 Feb;274(2):352–8.
Grimm, Lars J., et al. “Can breast cancer molecular subtype help to select patients for preoperative MR imaging?Radiology, vol. 274, no. 2, Feb. 2015, pp. 352–58. Pubmed, doi:10.1148/radiol.14140594.
Grimm LJ, Johnson KS, Marcom PK, Baker JA, Soo MS. Can breast cancer molecular subtype help to select patients for preoperative MR imaging? Radiology. 2015 Feb;274(2):352–358.

Published In

Radiology

DOI

EISSN

1527-1315

Publication Date

February 2015

Volume

274

Issue

2

Start / End Page

352 / 358

Location

United States

Related Subject Headings

  • Retrospective Studies
  • Receptor, erbB-2
  • Receptor, ErbB-2
  • Preoperative Care
  • Patient Selection
  • Nuclear Medicine & Medical Imaging
  • Middle Aged
  • Magnetic Resonance Imaging
  • Humans
  • Female