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Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients

Journal of Breast Cancer, 2023, 26(5), 115, pp.479-491 [Peer Reviewed Journal]

2023 Korean Breast Cancer Society 2023 Korean Breast Cancer Society ;ISSN: 1738-6756 ;EISSN: 2092-9900 ;DOI: 10.4048/jbc.2023.26.e35 ;PMID: 37704381

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  • Title:
    Prognostic Implication of Focal Breast Edema on Preoperative Breast Magnetic Resonance Imaging in Breast Cancer Patients
  • Author: Sung, Pamela ; Lee, Jong Yoon ; Cheun, Jong-Ho ; Choi, In Sil ; Park, Jin Hyun ; Park, Jeong Hwan ; Kim, Byoung Hyuck ; Oh, Sohee ; Chu, A Jung ; Hwang, Ki-Tae
  • Subjects: Original ; 일반외과학
  • Is Part Of: Journal of Breast Cancer, 2023, 26(5), 115, pp.479-491
  • Description: PURPOSEIn this study, we investigated the prognostic implications of focal breast edema on preoperative breast magnetic resonance imaging (MRI) in patients with breast cancer.METHODSData of 899 patients with breast cancer at a single institution were retrospectively analyzed. The patients were divided into an edema-positive group (EPG) and an edema-negative group (ENG) based on the presence of peritumoral, prepectoral, or subcutaneous edema. Two radiologists evaluated the presence or absence of focal edema and its subtypes on preoperative breast MRI. Clinicopathologic characteristics and survival outcomes were compared between the two groups and among the three subtypes using Pearson's χ² test, Kaplan-Meier estimator, and Cox proportional hazards model.RESULTSThere were 399 (44.4%) and 500 (55.6%) patients in the EPG and ENG, respectively. The EPG showed significantly higher rates of axillary lymph node metastasis (55.6% vs. 19.2%, p < 0.001) and lymphovascular invasion (LVI) (57.9% vs. 12.6%, p < 0.001) than the ENG. Patients in the EPG showed significantly worse overall survival (OS) rate (log-rank p < 0.001; hazard ratio [HR], 4.83; 95% confidence interval [CI], 2.56-9.11) and recurrence-free survival rate (log-rank p < 0.001; HR, 3.00; 95% CI, 1.94-4.63) than those in the ENG. After adjusting for other variables, focal breast edema remained a significant factor affecting the OS rate, regardless of the edema type. Specifically, the presence of subcutaneous edema emerged as the strongest predictor for OS with the highest HR (p < 0.001; HR, 9.10; 95% CI, 3.05-27.15).CONCLUSIONFocal breast edema on preoperative breast MRI implies a higher possibility of LVI and axillary lymph node metastasis, which can lead to a poor prognosis. A detailed description of focal breast edema, especially subcutaneous edema, on preoperative breast MRI may provide prognostic predictions. More intensive surveillance is required for patients with breast cancer and focal preoperative breast edema.
  • Publisher: Korean Breast Cancer Society
  • Language: English
  • Identifier: ISSN: 1738-6756
    EISSN: 2092-9900
    DOI: 10.4048/jbc.2023.26.e35
    PMID: 37704381
  • Source: KoreaMed Synapse
    PubMed Central
    KoreaMed Open Access
    DOAJ Directory of Open Access Journals
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