Correlation Study Between MRI Performance And Pathology Of Breast Invasive Ductal Carcinoma

Objective:It aimed to explore the correlation between biological factors and imaging performance by analyzing the differences in imaging manifestations of different subtypes of breast cancer,in order to improve the early diagnosis rate of patients with invasive breast cancer and predict the biological behavior of the tumor.Thus,the best treatment plan was provided as well as the most accurate prognostic evaluation.Methods:A total of 326 patients with invasive ductal carcinoma were retrospectively analyzed in this study,who were pathologically diagnosed in the Third Hospital of Nanchang from July 2019 to June 2020.According to the pathological immunohisto-chemical diagnosis,all patients were rolled into four groups,namely a Luminal A group(57 cases),a Luminal B group(124 cases),a human epidermal growth factor receptor-2(HER-2)overexpression group(103 cases),and a triple negative group(42cases).All patients did not receive any relevant treatments before the surgery,while they successfully underwent dynamic contrast-enhanced(DCE)-magnetic resonance imaging(MRI)examinations,postoperative pathological slices,and immunohisto-chemical marker examinations.Then,all imaging-related tumor morphological features were recorded,including whether there was a mass,tumor size,tumor edge(smooth,burr,and unsmooth),hemodynamic characteristics,DCE-MRI curve type(platform,clearance,and ascending curve),tumor signal enhancement rate,peak time,apparent diffusion coefficient(ADC),and early intensive rate(EER).The postoperative tumor lymph node metastasis status,tumor location,number of lesions,and World Health Organization(WHO)classification should also be counted.Results:1.Among the 326 cases of invasive ductal carcinoma,the age composition of the subjects was mainly from 41 to 60 years old,a total of 288 subjects(63.80%);45patients(13.81%)were 61 years old or older;73 patients(22.39%)were aged 40 years or younger.2.Pathological findings: 57 cases(17.48%)of Luminal A type;Luminal-B type124 cases(38.04%);103 cases(31.60%)had Her-2 overexpression.Triple negative42 cases(12.88%).Most cases were ER positive(230 cases,70.55%).Most of the cases(57.67%)were positive for PR.224 patients(62.71%)were negative for Her-2.250 cases(78.53%)were positive for Ki-67.P53 negative in 210 cases(63.06%);The main lesions were Ⅱ grade and Ⅱ grade 154(49.20%)and 152(48.56%),respectively.In this group,there were 119 cases(36.5%)with axillary lymph node metastasis,and the maximum number of axillary lymph node metastasis was 24,with an average number of 1.53.3.MRI features: the lesion morphology was mainly mass type,accounting for82.82%;The edge was dominated by burr,accounting for 55.56%.The main curve type was Ⅱ type,accounting for 55.56%.The average value of ADC was(0.87±0.16)×10-3mm2/s,and the average value of early enhancement rate was(196.81±69.85)%.The average peak time was(2.14±0.80)min.4.The differences in morphology,edge and curve types of lesions with different molecular types were statistically significant(P<0.05).There were no significant differences in ADC value,early enhancement rate and peak time among different molecular types(P>0.05).The mass type was more common in triple negative patients,while the proportion of non-mass shape and irregular edge in patients with HER-2 overexpression was higher than that in patients with other molecular types.The ratio of Ⅱ curve in tri-negative patients was higher than that in other groups.The proportion of Luminal-B patients with Ⅲ curve was higher than that of other groups.Patients with Luminal-B type had the lowest ADC and the highest rate of early enhancement.The patients with Her-2 overexpression had the shortest peak time.5.The tumor rate of ER positive group was higher than that of negative group(P=0.036).The morphology of the HER-2 negative and positive groups was different(P<0.001),suggesting that the tumor rate in the HER2-negative group was higher than that in the positive group.The margins of the HER-2 negative and positive groups were different(P<0.001),and marginal burrs were common in the HER-2positive group.Patients with ER negative,PR negative and P53 gene mutation were more likely to have lymph node metastasis.Conclusion:1.Different molecular subtypes of invasive ductal carcinoma have differences in morphology,margin and pathological grade.2.Some MRI features of infiltrating ductal carcinoma with different molecular subtypes are different,and some MRI features are correlated with biological factors to a certain extent.Therefore,the expression of molecular subtypes and biological factors of infiltrating ductal carcinoma can be inferred based on MRI features.