Magnetic Resonance Multimodality Diagnosis Of Non-specific Invasive Breast Cancer And Its Correlation With Prognostic Factors

Part one: Magnetic resonance multi-modal diagnosis of breast non-special type invasive carcinomaObjective: To study the imaging characteristics of multimode magnetic resonance imaging in breast non-special type invasive carcinoma?Materials and MethodsRetrospective analysis of our hospital from January 2016 to January 2017 menstrual pathology confirmed 150 cases of breast lesions in patients with magnetic resonance data,including 69 cases of non-special type of invasive carcinoma,21 cases of other types of breast cancer and 60 cases of benign breast lesions.All patients underwent preoperative magnetic resonance imaging,the diagnostic characteristics of the classification,time to peak,ADC value,rADC value,enhancement peak value,maximum signal intensity difference and early enhancement rate of all lesion size,shape,edge and time signal were analyzed.Using SPSS19.0 statistical software analysis,Continuous variables are expressed as mean ± standard deviation,and categorical variables are expressed as a percentage.Count data were tested by X2,and the data were analyzed by one-way ANOVA.P <0.05 was considered statistically significant.Results:The mean diameter(19.82 ± 8.98 mm)of non-special type invasive carcinoma was not significantly different from that of other types of breast cancer(23.47 ± 13.42 mm),Both were greater than the mean of benign lesions(14.91 ± 9.22 mm).Benign lesions are mostly round or oval,malignant lesions are mostly lobulated or irregular shape(X2=14.002,P=0.000<0.05),the difference was statistically significant,There was no significant difference between non-special type invasive carcinoma and other types of breast cancer(X2=0.912,P=0.634>0.05).Benign lesions mostly smooth margins,malignant lesions mostly irregular or burr(X2=47.594,P =0.000<0.05),the difference was statistically significant,there was no significant difference between non-special type invasive carcinoma and other types of breast cancer(X2=0.652,P=0.722>0.05).Benign lesions were mostly uniform enhanced,malignancy mostly non-uniform or annular enhancement(X2=45.119,P=0.000<0.05),the difference was statistically significant,there was no significant difference between non-special type invasive carcinoma and other types of breast cancer(X2=1.418,P=0.492>0.05).Benign disease time signal enhancement curve for the type I,malignant lesions mostly II-III type(X2=21.782,P =0.000<0.05),the difference was statistically significant,there was no significant difference between non-special type invasive carcinoma and other types of breast cancer(X2=5.846,P=0.054>0.05).Maglignant lesions of the time to peak in the first 3 minutes,benign lesions in 4to 5 minutes(X2=29.754,P =0.000 < 0.05),the difference was statistically significant,non-special type invasive carcinoma in 2 minute,before more earlier other types of breast cancer(X2=3.903,P =0.048<0.05),the difference was statistically significant.Non-specific type of invasive cancerADC value(0.831±0.194×10-3mm2/s)<other types of breast cancerADC value(1.034±0.346×10-3mm2/s)<benign lesions ADC value(1.327±0.385×10-3mm2/s).Non-specific type of invasive cancer rADC value of 0.52 ± 0.15,other types of breast cancer rADC value of 0.60 ± 0.26,benign lesions rADC value of 0.78 ± 0.25;rADC values were not significantly different between non-specific types of invasive carcinoma and other types of breast cancer,both lower than benign lesions.There was no significant difference between the peak value of non-special invasive carcinoma(563.89±238.2)and other types of breast cancer(500.86±158.78),both were lower than that of benign lesions(650.33±232.03).There was no significant difference between the maximum signal difference of non-specific type of invasive carcinoma(389.86±179.31)and other types of breast cancer(335.71±127.64),both were lower than that of benign lesions(453.95±182.45).Non-specific type of invasive carcinoma first minute enhancement rate(177.43%±58.04%),other types of breast cancer first minute enhancement rate(171.97%±52.74%),benign lesion first minute enhancement rate(173.08%±78.18%),there was no significant difference between the three groups.Conclusions1 There was no significant difference in the size,shape,edge,enhancement characteristics,TIC morphology,rADC value,peak value,and maximum signal difference between the non-specific type of invasive carcinoma and other types of breast cancer,but there was a statistically significant difference between benign and malignant lesions.2 Breast non-special type of invasive cancer time to peak earlier than other types of breast cancer,both are earlier than benign lesions.Non-specific type of invasive carcinoma ADC value is lower than other types of breast cancer,both are lower than benign lesions.Part two: Analysis of correlation between multimode magnetic resonance and prognostic factors of non-specific invasive carcinoma.Purpose: To study the correlation between multimode magnetic resonance imaging and prognostic factors in non-specific types of invasive breast cancerMaterials and MethodsMagnetic resonance imaging of 110 non-specific type of invasive breast cancer patients with pathologically confirmed were retrospectively analyzed.The images were analyzed and diagnosed separately by two senior physicians with blind method.The correlation between the morphology of the lesion,the edge,the internal enhancement,the time signal intensity curve,the maximum length and the expression of the prognostic factors ER,PR,HER-2,Ki-67,CK5/6,P53,EGFR,lymph node in the surgical area were detected.Using SPSS19.0 statistical software: use the Spearman rank correlation analysis the correlation of the dynamic enhancement of magnetic resonance performance and the prognostic factors,P < 0.05 for the difference was statistically significant.ResultThere was a positive correlation between morphological irregularity and high expression of Ki-67(r = 0.309,P = 0.001).There was a positive correlation between edge burr and ER(r=0.242,p=0.011)and high expression of PR(r=0.214,p=0.025),and negatively correlated with high expression of Ki-67.There was a positive correlation between ring enhancement and positive lymph node(r = 0.274,P = 0.004)..There was a positive correlation between time-signal intensity curve type-III and the high expression of Ki-67(r = 0.191,p = 0.045),the high expression of EGFR(r = 0.198,P = 0.038),and the high expression of CK5/6(R = 0.260,P = 0.006).There was a positive correlation between the diameter of the lesion and the high expression of Ki-67(r = 0.291,P = 0.002);the high expression of p53(r = 0.266,P = 0.005),the positive lymph node(r = 0.379,P = 0.000).Conclusions1 The magnetic resonance characteristics of invasive carcinoma of non-special type were significantly correlated with ER?PR?Ki-67?p53?EGFR?CK5/6 and lymph node metastasis.2 The magnetic resonance is an important reference for clinical choice of treatment.