Value of the 3.0-T DCE-MRI features in the assessment of the risk of axillary lymph node metastasis in breast cancer

ObjectiveTo investigate the value of multimodal dynamic contrast enhanced magnetic resonance imaging(DCE-MRI) in predicting the risk of axillary lymph node metastasis(ALNM) in breast cancer patients.

MethodsThe preoperative clinical and imaging data of 54 patients with breast cancer confirmed by surgical pathology were retrospectively analyzed.The multimodal DCE-MRI scan in all cases were detected before surgery.The patients were divided into the axillary lymph node metastasis group(ALNM+, n=19) and the non-axillary lymph node metastasis group(ALNM-, n=35) according to the presence or absence of ALNM.The correlation between the clinical and DCE-MRI features and ALNM were analyzed in two groups.

ResultsThe general clinical data of 54 breast cancer patients(including age, menopausal history, fertility history, mass texture and mass activity) were not related to ALNM(P>0.05).In terms of multimodal DCE-MRI features, the proportion of patients with blurred mass edges in ALNM positive group was significantly higher than that in ALNM negative group(P < 0.01).The ADC in ALNM positive group was significantly lower than that in ALNM negative group(P < 0.01).The proportion of ALN ≥ 0.5 cm in ALNM positive group was significantly higher than that in ALNM negative group(P < 0.05).The results of multivariate analysis showed that the ADC value and tumor margin were the independent risk factors of ALNM in breast cancer(P < 0.01).In addition, the AUC, sensitivity, specificity and cut-off values of ADC values were the 0.743, 78.9%, 71.4% and 0.912×10^-3mm²/s, respectively.The AUC, sensitivity and specificity of mass margin were the 0.750, 84.2% and 65.6%, respectively.

ConclusionsThe marginal features of multimodal DCE-MRI, ADC value and risk factors of ALNM in breast cancer are helpful for the development of treatment plan and prognosis evaluation of breast cancer patients.