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Vol. 62. Issue 5.
Pages 365-375 (September - October 2020)
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Vol. 62. Issue 5.
Pages 365-375 (September - October 2020)
Original article
DOI: 10.1016/j.rxeng.2020.03.002
Analysis of the radio-pathological factors of triple negative breast cancer and determination of risk profiles
Análisis de los factores radiopatológicos del cáncer de mama triple negativo y determinación de perfiles de riesgo
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C. Sebastián Sebastiána,
Corresponding author
crissebseb@gmail.com

Corresponding author.
, C. García Mura, B. Gros Bañeresb, S. Cruz Ciriaa, D.S. Rosero Cuestac, I. Suñén Amadora
a Sección de Radiología Mamaria, Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, Spain
b Servicio de Urgencias, Hospital Universitario Miguel Servet, Zaragoza, Spain
c Servicio de Anatomía Patológica, Hospital Universitario Miguel Servet, Zaragoza, Spain
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Table 1. Results of factors assessed in staging MRI.
Table 2. Results of the anatomopathological factors.
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Abstract
Objective

Triple-negative tumours are the most aggressive type of breast cancer. We aimed to analyse the main radiologic and histopathologic factors of these tumours to create a risk profile.

Materials and methods

We analysed data from 140 patients diagnosed with triple-negative breast cancer between January 2007 and December 2016, with follow-up through April 2018. We analysed the following variables in the breast MRI done for staging: size, necrosis, associated findings, adenopathies, and perfusion and diffusion parameters. We analysed the following variables in histopathologic studies of biopsy specimens: histological type, Scarf-Bloom, Ki67, and p53 in the infiltrating component as well as in the in situ component. We analysed the following variables in histopathologic studies of positive lymph nodes and surgical specimens: size, lymphovascular/perineural invasion, and microglandular adenosis. We analysed the relation between the radiologic and histopathologic factors and recurrence and disease-free survival.

Results

MRI tumour size ≥25mm, non-nodular enhancement, breast oedema, areola-nipple complex retraction, and lymph-node involvement were associated with recurrence and lower disease-free survival. Invasive lobular carcinoma, postsurgical size ≥20mm, and p53<15% were also associated with recurrence and lower disease-free survival. Histologically positive lymph nodes were associated with a greater percentage of recurrence and lymphovascular invasion and with lower disease-free survival. The multivariate analysis found that the variables MRI size ≥25mm, non-nodular enhancement, adenopathies on MRI, and p53 expression <15% were independent predictors of lower disease-free survival.

Conclusions

In triple-negative breast tumours, factors associated with lower disease-free survival are non-nodular enhancement, size ≥25mm, and adenopathies on MRI, and p53 expression <15% on histopathologic study.

Keywords:
Triple-negative
Breast cancer
Recurrence
Survival
Radio-pathological factors
Resumen
Objetivo

Los tumores triples negativos (TN) constituyen el subgrupo de cáncer de mama (CM) más agresivo. Nuestro objetivo es analizar los principales factores radiopatológicos de estos tumores para crear un perfil de riesgo.

Materiales y métodos

Es un estudio constituido por 140 pacientes diagnosticadas de CM TN desde enero del 2007 a diciembre del 2016. Se analizaron los factores radiológicos en resonancia magnética (RM) de estadificación: tamaño, necrosis, hallazgos asociados, adenopatías, parámetros de perfusión y difusión. En biopsias diagnósticas se estudiaron características del componente infiltrante: tipo histológico, Scarf-Bloom, Ki67 y p53 y el componente in situ. Se analizaron las adenopatías histológicamente positivas y en las piezas quirúrgicas: tamaño, invasión linfovascular/perineural y adenosis microglandular. El seguimiento finalizó en abril de 2018. Se evaluó la relación de los factores radiopatológicos con la recidiva y la supervivencia libre de enfermedad (SLE).

Resultados

Los tumores con tamaño igual o superior a 25mm en RM, realce no nodular, edema mamario o retracción del complejo aréola-pezón y adenopatías presentaron más recidivas y menor SLE. Los carcinomas lobulillares infiltrantes, el tamaño posquirúrgico20mm y p53<15% también se asociaron con la recidiva y una menor SLE. Las adenopatías histológicamente positivas se relacionaron con un mayor porcentaje de recidivas, y la invasión linfovascular, con una menor SLE. El análisis multivariante ha definido que el tamaño en RM25mm, el realce no nodular, las adenopatías en RM, y la expresión menor del 15% de p53 son variables pronósticas independientes.

Conclusiones

El tamaño igual o superior a 25mm, realce no nodular y adenopatías en RM, y una expresión inferior al 15% de p53 condicionan una menor SLE.

Palabras clave:
Triple negativo
Cáncer de mama
Recidiva
Supervivencia
Factores radiopatológicos

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