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Background: We wanted to examine whether the apparent
diffusion coefficient values obtained by diffusion-weighted imaging techniques
could indicate an early prognostic assessment for patients with invasive ductal
carcinoma and therefore, influence the treatment decision making.
Objective: The main objective was to evaluate the
correlation between the apparent diffusion coefficient values obtained by
diffusion-weighted imaging and the key prognostic factors in breast invasive
ductal carcinoma. Secondary objectives were to analyze the eventual
correlations between magnetic resonance imaging findings and prognostic factors
in breast cancer; and to perform a comparison between results in 1.5 and 3.0 T
scanners.
Methods: Breast magnetic resonance imaging with
diffusion-weighted imaging sequence was performed on 100 patients, who were
proven histopathologically to have breast invasive ductal carcinoma. We
compared the apparent diffusion coefficient values, obtained previous to
biopsy, with the main prognostic factors in breast cancer: tumor size,
histologic grade, hormonal receptors, Ki67 index, human epidermal growth factor
receptor type 2 and axillary lymph node status. The Mann-Whitney U test and the
Kruskal-Wallis analysis were used to establish these correlations.
Results: The mean apparent diffusion coefficient value
was inferior in the estrogen receptor-positive group than in the estrogen
receptor-negative group (1.04 vs. 1.1710-3 mm2/s, P=0.004). Higher
histologic grade related to larger tumor size (P=0.002). We found association
between spiculated margins and positive axillary lymph node status (odds
ratio=4.35 (1.49-12.71)). There were no differences in apparent diffusion
coefficient measurements between 1.5 and 3.0 T magnetic resonance imaging
scanners (P=0.513). Conclusions: Low apparent diffusion coefficient values are
related with positive expression of estrogen receptor. Larger tumors and
spiculated margins are associated to worse prognosis. Rim enhancement is more
frequently observed in estrogen receptor-negative tumors. There are no
differences in apparent diffusion coefficient measurements between different
magnetic resonance imaging scanners.
Keywords: Breast ductal carcinoma, Breast neoplasms,
Diffusion magnetic resonance imaging, Magnetic resonance imaging, Prognosis
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