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Clinical findings and outcomes of MRI staging of breast cancer in a diverse population.

ABSTRACT: BACKGROUND:The performance of magnetic resonance imaging (MRI), the effect of patient factors, and resulting surgical management in underserved and ethnically diverse breast cancer (BC) patient populations have been understudied. METHODS:We retrospectively analyzed the data of 1116 consecutive patients who were newly diagnosed with in situ or invasive BC with preoperative staging MRI. Non-index lesions (NILs) were defined as abnormal MRI findings with BI-RADS score of 4 or 5 in breast or axillary nodes not previously detected by conventional imaging. Occult cancers (OCs) were NILs found to be malignant by biopsy or surgery. Logistic regression was used to examine associations between probabilities of NILs or OCs and patient characteristics. RESULTS:Staging MRI detected NILs and OCs in 24% and 7.5% of patients, respectively. Of 1116 patients, 271 (24%) had 327 NILs, and 84 (7.5%) had 87 OCs. Follow-up information was available for 306 NILs. Ipsilateral breast NILs (n?=?124) were seen in 115 patients (10.3%), with OCs (n?=?51) seen in 48 patients (4.4%). Contralateral breast NILs (n?=?134) were seen in 118 (10.6%) patients, with OCs (n?=?20) seen in 20 patients (1.8%). Laterality (p?

SUBMITTER: Raghavendra A

PROVIDER: S-EPMC7494176 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature

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Clinical findings and outcomes of MRI staging of breast cancer in a diverse population.

Raghavendra Akshara A Wecsler Julie J Ji Lingyun L Sheth Pulin P Ricker Charite C Church Terry T Sposto Richard R Lang Julie J Sener Stephen S Larsen Linda L Tripathy Debu D

Breast cancer research and treatment 20181212 2

<h4>Background</h4>The performance of magnetic resonance imaging (MRI), the effect of patient factors, and resulting surgical management in underserved and ethnically diverse breast cancer (BC) patient populations have been understudied.<h4>Methods</h4>We retrospectively analyzed the data of 1116 consecutive patients who were newly diagnosed with in situ or invasive BC with preoperative staging MRI. Non-index lesions (NILs) were defined as abnormal MRI findings with BI-RADS score of 4 or 5 in br ...[more]

PMID: 30542816

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Project description:BackgroundCardiac magnetic resonance (CMR) global longitudinal strain and circumferential strain abnormalities have been associated with left ventricular ejection fraction (LVEF) reduction and cardiotoxicity from oncologic therapy. However, few studies have evaluated the associations of strain and cardiovascular outcomes.ObjectivesTo assess CMR circumferential and global longitudinal strain (GLS) correlations with cardiovascular outcomes including myocardial infarction, systolic dysfunction, diastolic dysfunction, arrhythmias and valvular disease in breast cancer patients treated with and without anthracyclines and/or trastuzumab therapy.MethodsBreast cancer patients with a CMR from 2013-2017 at Yale New Haven Hospital were included. Patient co-morbidities, medications, and cardiovascular outcomes were obtained from chart review. Biostatistical analyses, including Pearson correlations, competing risk regression model, and competing risk survival curves comparing the two groups were analyzed.Results116 breast cancer with CMRs were included in our analysis to assess differences between Anthracycline/Trastuzumab (AT) (62) treated versus non anthracycline/trastuzumab (NAT) (54) treated patients in terms of imaging characteristics and outcomes. More AT patients 17 (27.4%) developed systolic heart failure compared to the NAT group 6 (10.9%), p = 0.025. Statin use was associated with a significant reduction in future arrhythmias (HR 0.416; 95% CI 0.229-0.755, p = 0.004). In a sub-group of 13 patients that underwent stress CMR, we did not find evidence of microvascular dysfunction by sub-endocardial/sub-epicardial myocardial perfusion index ratio after adjusting for ischemic heart disease.ConclusionsIn our study, CMR detected signs of subclinical cardiotoxicity such as strain abnormalities despite normal LV function and abnormal circumferential strain was associated with adverse cardiovascular outcomes such as valvular disease and systolic heart failure. Thus, CMR is an important tool during and after cancer treatment to identity and prognosticate cancer treatment-related cardiotoxicity.

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Clinical findings and outcomes of MRI staging of breast cancer in a diverse population.

Publications

Clinical findings and outcomes of MRI staging of breast cancer in a diverse population.

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