31P - Prognostic implication of breast edema on preoperative breast MRI in breast cancer

Background

Breast edema is defined as a high signal intensity on T2-weighted magnetic resonance imaging (MRI), and it is an essential image phenotype of breast MRI. The purpose of this study was to investigate the prognostic implication of breast edema on preoperative breast MRI in breast cancer patients.

Methods

We retrospectively analyzed the data of 899 breast cancer patients at a single institution. Patients were divided into the edema-positive group (EPG) and the edema-negative group (ENG) according to the presence of breast edema on preoperative breast MRI. We compared the clinicopathologic characteristics and the survival outcomes between the two groups. A two-sample t-test was used to determine statistical differences between mean ages, and Pearson’s χ2 test was used to determine statistical differences between all the other baseline characteristics. The log-rank test was used to compare the survival curves from Kaplan–Meier estimator. The Cox proportional hazards model was used to calculate the hazard ratio (HR) and 95% confidence interval (CI).

Results

There were 399 (44.4%) patients in the EPG and 500 (55.6%) patients in the ENG. Among patients in the EPG, peritumoral, prepectoral, and subcutaneous edemas were present in 387, 130, and 66 patients, respectively. 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 ENG. Patients in the EPG showed significantly worse overall survival rate (log-rank p < 0.001; HR: 4.83; 95% 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, breast edema still remained a significant factor affecting overall survival rate regardless of edema type.

Conclusions

Breast edema on preoperative breast MRI is strongly correlated with several clinicopathological features including nodal metastasis and LVI in breast cancer patients. It significantly affects the survival rate and disease recurrence of breast cancer patients. Therefore, detailed descriptions of breast edema in preoperative breast MRI may provide prognosis prediction and more intensive surveillance is needed for breast cancer patients with breast edema.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The author.

Funding

Has not received any funding.

Disclosure

The author has declared no conflicts of interest.