Correlations between dynamic contrast-enhanced magnetic resonance imaging parameters and histopathologic factors in breast cancer.

BACKGROUND: This study aimed to correlate dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) parameters with prognostic factors in breast cancer. METHODS: A retrospective analysis was performed in 45 patients who had breast DCE-MRI and were diagnosed with invasive ductal breast cancer following surgery. The following DCE-MRI parameters were calculated: percentage of initial peak enhancement (Epeak), time to initial peak enhancement (TTP), initial slope increase (IS), early signal enhancement ratio (ESER), and time-signal intensity curve (TIC) types. Correlations between Epeak, TTP, IS, ESER, and prognostic factors were determined using the Mann-Whitney U test and the Kruskal-Wallis test. The Chi-square test and Fisher's exact test were used to investigate the relationship between kinetic curve types and prognostic factors. RESULTS: Epeak and IS were significantly higher in the Ki-67 high-expression group than in the Ki-67 low-expression group (p = 0.031 and p = 0.012, respectively). ESER was significantly correlated with the histological type and Ki-67 expression level (p = 0.014 and p = 0.047, respectively). The TIC types were significantly correlated with the Ki-67 expression level (p = 0.009). Tumors with plateaus and washout curves were more likely to be associated with the Ki-67 high-expression group than tumors with a persistent curve (P = 0.027 and P = 0.038, respectively). TTP had no correlation with any prognostic factors (P > 0.05). CONCLUSIONS: This study showed that the DCE-MRI parameters of breast cancer were correlated with the expression of histopathological prognostic factors and might be useful for predicting prognosis.

Correlations between apparent diffusion coefficient values and histopathologic factors in breast cancer.

BACKGROUND: Breast cancer is the most common malignancy dia-gnosed in women, and the incidence gradually increases. Magnetic resonance imaging (MRI) is become widely used to identify benign and malignant breast tumors. Objective: The aim of this study was to evaluate the relationships between apparent diffusion coefficient (ADC) values and histopathologic prognostic factors in breast cancer. METHODS: Forty-nine breast carcinoma patients were included evaluated for prognostic factors, including histological type, histo-logical grade, estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and molecular subtype. Minimum (ADCmin) and mean (ADCmean) ADC values were compared among prognostic factor groups by Mann-Whitney U test and Kruskal-Wallis test. RESULTS: Lower mean ADCmin and ADCmean values were observed for no special type (NST) than for invasive lobular carcinoma (ILC) type (0.81 ± 0.03 × 10-3 and 0.96 ± 0.03 × 10-3 mm2/s, P= 0.002 and 0.03, respectively). The mean ADCmin and ADCmean values for the high-level Ki-67 group were significantly lower than those for the low-level Ki-67 group (P = 0.001 and 0.008, respectively). No correlations were observed between ADC values and histological grades, ER, PR, HER2, and molecular subtypes. CONCLUSION: ADCmin and ADCmean values correlated with the pro-liferation marker Ki-67 and histological grade. ADC values can serve as noninvasive indicators of cell proliferation in breast cancer.

Enlarged accessory spleen after splenectomy mimicking a pancreas tumor.

INTRODUCTION: An accessory spleen (AS), a common condition, is usually located in the hilar region of the spleen. ASs are not often large; however, after splenectomy, the initially inactive AS may become reactive and hypertrophic. Therefore, an AS can be misdiagnosed as a neoplastic tumor and removed unnecessarily. An undiagnosed abdominal mass located in the spleen site in a patient who has had a splenectomy must be managed carefully. Computed tomography (CT) scanning and magnetic resonance imaging (MRI) may provide useful information for the diagnosis, preventing unnecessary surgery. CASE PRESENTATION: Herein, we report the case of a 38-year-old female with an enlargement of AS after splenectomy that was misdiagnosed as a primary tumor of the pancreas and managed by a nonessential surgery. CONCLUSION: An AS should be added to the differential diagnosis of a pancreatic tail tumor for patients with prior splenectomy in order to avoid nonessential surgery to ensure the patient's safety.