| Abstract | Svrha rada. Svrha istraživanja je analizirati povezanost karakteristika duktalnoga
invazivnoga karcinoma (IDC) dojke dobivenih magnetnom rezonancijom (MR) s
patohistološkim prognostičkim pokazateljima te s molekularnim podtipovima karcinoma
dojke.
Metode. U ovo retrospektivno istraživanje je bilo uključeno 114 bolesnica s IDC-om dojke
kod kojih je učinjen preoperativni MR pregled. Analizirane su morfološke i kinetičke
karakteristike IDC-a, koje su potom interpretirane pomoću Göttingenskog sustava bodovanja
(GS). Uvidom u konačni patohistološki nalaz utvrđena je veličina tumora, status aksilarnih
limfnih čvorova, histološki gradus, limfovaskularna invazija, estrogenski receptori (ER),
progesteronski receptori (PR), ekspresija HER2 i proliferacijski indeks (Ki-67).
Rezultati. Multivarijatna analiza je pokazala da su glatki rubovi značajan neovisan prediktor
većeg tumora (p=0.041), pozitivnih aksilarnih limfnih čvorova (p=0,013) i negativnih ER
(p=0.022). Veći GS je bio značajan neovisni prediktor višeg histološkog gradusa (p=0.022),
dok je okrugli ili ovalni oblik bio neovisan prediktor pozitivnih PR (p=0,027).
Zaključak. Otkrivanje glatkih rubova pri MR-u je klinički bitna odrednica prognoze
karcinoma dojke budući da su glatki rubovi značajan neovisan prediktor više nepovoljnih
prognostičkih pokazatelja, i to veličine tumora, pozitivnih aksilarnih limfnih čvorova te
negativnih ER. Osim s višim histološkim gradusom, GS nije bio značajno povezan s ostalim
nepovoljnim prognostičkim pokazateljima, vjerojatno zbog činjenice da se prema ovom
sustavu bodovanja glatkim rubovima dodjeljuje manje bodova nego spikuliranim rubovima. |
| Abstract (english) | Objective. The aim of this study was to correlate magnetic resnonace imaging (MRI) features
of invasive ductal carcinomas (IDC) with pathohistological prognostic factors, as well as with
molecular subtypes of breast cancer. Such an association, if present, could have significant
translational implications for early identification of aggressive types of breast cancer, where
rapid identification can expedite tumor treatment.
Methods. 114 women with IDC who underwent breast MRI within one month prior to
surgery were included in this retrospective study. MRI features were analyzed and then
interpreted with a Göttingen score (GS) that included morphological (shape, margins and
pattern of enhancement) and kinetic characteristics (initial signal increase and post-initial
behaviour of the time-signal intensity curve). Histological specimens were analyzed for tumor
size, axillary lymph node status, histological grade, estrogene receptors (ER), progesterone
receptors (PR), HER2, and Ki-67.
Results. By multivariate analysis, a smooth margin was a significant, independent predictor
of a larger tumor size (p=0.041), lymph node invasion (p=0,013), and lower expression of ER
(p=0.022). High GS was significant, independent predictor of a higher histological grade
(p=0.022) while round or oval shape of lesion was independent predictor of a higher PR
expression (p=0,027).
Conclusion. A smooth margin of breast cancer on breast MRI was able to predict positive
axillary lymph nodes, larger tumor size and lower expression of ER. Except for a higher
histological grade, GS was not able to predict other unfavourable prognostic factors, mainly
due to the fact that smooth margins were assigned less points than spiculated margins. |
