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Risk Factors for Lymphovascular Invasion in Invasive Ductal Carcinoma Based on Clinical and Preoperative Breast MRI Features: a Retrospective Study

  • Author Footnotes
    # These authors contributed equally to this study.
    Cici Zhang
    Footnotes
    # These authors contributed equally to this study.
    Affiliations
    Department of Radiology, The Third Affiliated Hospital, Southern Medical University, Address, No. 183, West Zhongshan Avenue, TianHe District Guangzhou, GuangDong China

    Department of Radiology, Guangzhou Red Cross Hospital, Guangzhou, China
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  • Author Footnotes
    # These authors contributed equally to this study.
    Zhiping Liang
    Footnotes
    # These authors contributed equally to this study.
    Affiliations
    Department of Radiology, Guangzhou Red Cross Hospital, Guangzhou, China
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  • Author Footnotes
    # These authors contributed equally to this study.
    Youzhen Feng
    Footnotes
    # These authors contributed equally to this study.
    Affiliations
    Medical Imaging Center, The First Affiliated Hospital of Jinan University, Guangzhou, China
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  • Yuchao Xiong
    Affiliations
    Department of Radiology, Guangzhou Red Cross Hospital, Guangzhou, China
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  • Chan Manwa
    Affiliations
    Department of Pediatrics, Kiang Wu Hospital, Macau, China
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  • Quan Zhou
    Correspondence
    Address correspondence to: Q.Z.
    Affiliations
    Department of Radiology, The Third Affiliated Hospital, Southern Medical University, Address, No. 183, West Zhongshan Avenue, TianHe District Guangzhou, GuangDong China
    Search for articles by this author
  • Author Footnotes
    # These authors contributed equally to this study.
Published:November 19, 2022DOI:https://doi.org/10.1016/j.acra.2022.10.029

      Rationale and Objectives

      Lymphovascular invasion (LVI) plays an important role in the prediction of metastasis and prognosis in breast cancer (BC) patients. The present study assessed correlations between preoperative breast MRI, clinical features, and LVI in patients with invasive ductal carcinoma (IDC) and identified risk factors based on these correlation factors.

      Materials and Methods

      Patients confirmed with IDC between 01/2012 and 12/2021 were retrospectively reviewed at our hospital. A total of 5 clinical and 14 MRI features to characterize tumours were extracted. LVI evaluated in hematoxylin and eosin sections. T-test and chi-square tests were used to compare the differences in clinical and MRI features between the LVI positive and negative groups. The associations between individual features and LVI were analysed by univariable logistic regression analysis, and risk factors for LVI were identified by multivariable logistic regression analysis based on these correlation factors.

      Results

      This study included 353 patients with IDC, including 130 with positive LVI. Age, CEA, CA-153, amount of fibroglandular tissue (FGT), background parenchymal enhancement, tumour size, shape, skin thickening, nipple retraction, adjacent vessel sign, and axillary lymph node (ALN) size in the LVI positive group were significantly different from the LVI negative group (all p<0.05). Multivariate logistic regression analysis revealed that age (odds ratio OR = 1.030), CA-153 (OR = 1.018), heterogeneous FGT (OR = 2.484), shape (OR = 2.157), and ALN size (OR = 1.051) were risk factors for LVI (all p<0.05).

      Conclusion

      Preoperative breast MRI and clinical features correlated with LVI, age, CA-153, heterogeneous FGT, shape, and ALN size are risk factors for LVI in patients with IDC.

      Key Words

      Abbreviations:

      BC (Breast cancer), LVI (Lymphovascular invasion), IDC (Invasive ductal carcinoma), CEA (Carcinoembryonic antigen), CA15-3 (Cancer antigen 15-3), FS-T2WI (Fat-suppressed-T2-weighted images), BI-RADS (Breast Imaging Reporting and Data System), FGT (Fibroglandular tissue), BPE (Background parenchymal enhancement), ALN (Axillary lymph node), OR (Odds ratio), CI (confidence interval)
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