Correlation Between MRI Features Of Invasive Ductal Carcinoma Of The Breast And Axillary Lymph Node Metastasis

Objective:Summarize the magnetic resonance image characteristics of patients with infiltrated duct cancer,and study the correlation with the metastasis of axillary lymph nodes.Methods:A retrospective analysis was conducted on 121 patients diagnosed with breast infiltrating duct carcinoma in our hospital from May 2018 to July 2022.According to postoperative pathology,the patients were divided into the axillary lymph node metastasis group（51 cases）and without axillary lymph node metastasis group（70 cases）.Magnetic resonance imaging features of the two groups of patients were collected,including patient age,peritumoral edema of the primary lesion,the maximum diameter of the primary lesion,shape,edge,TIC curve type,ADC value,and early enhancement rate.The measured data were continuous,and if they obey the normal distribution,the comparison between groups uses an independent sample t test,if they do not obey the normal distribution,the comparison between groups uses non-parametric rank sum test.Comparison between counting data groups use X² test.Multivariate logistic regression analysis was carried out for the meaningful parameters of univariate analysis.P<0.05 was considered to be statistically significant.Finally,the parameters of statistically significant are analyzed by the receiver operating characteristic curve（ROC）to calculate the highest Yoden index,and obtain the optimal critical value,sensitivity and specificity.Results:Firstly,the ADC value is analyzed by the ROC curve,and the optimal critical value of ADC was is 0.892×10^-3mm²/s.According to the optimal critical value,it is divided into high ADC value group and low ADC value group,and the ADC value was converted into classification variable.The peritumoral edema,shape,margin,ADC value and TIC curve type of the primary lesion were performed X² test,among which peritumoral edema and ADC value was statistically significant between axillary lymph node metastasis group and without axillary lymph node metastasis group（P<0.05）,the other differences were not statistically significant（P>0.05）.Independent sample t test was performed for age,maximum diameter of primary lesion,and early enhancement rate.There were statistically significant differences in maximum diameter of primary lesion,and early enhancement rate between axillary lymph node metastasis group and without axillary lymph node metastasis group（P<0.05）,there was no significant difference in age（P>0.05）.Multivariate logistic regression analysis are performed on the maximum diameter of primary lesion,ADC value and early enhancement rate,the results show that they are all independent risk factors.Peritumoral edema,maximum diameter of primary lesion,ADC value,early enhancement rate and the four parameters were combined to predict axillary lymph node metastasis for the ROC curve analysis,the sensitivity of peritumoral edema was 78.4%,and the specificity was 67.1%,the optimal cut-off value of the maximum diameter of the primary lesion was 2.85cm,with a sensitivity of 74.5%and a specificity of 71.4%.the sensitivity of ADC value was 70.6%and a specificity of 81.4%,the best critical value of early enhancement rate was 183.64%,the sensitivity was 70.6%,and the specificity was 85.7%.The AUC of combined prediction of peritumoral edema,maximum diameter of primary lesion,ADC value and early enhancement rate was 0.939,with a sensitivity of 90.2%and a specificity of 88.6%.The sensitivity and specificity of joint prediction were higher than those of independent prediction.Conclusions:1.Maximum diameter of primary lesion,peritumoral edema,ADC value,and early enhancement rate predicted axillary lymph node metastasis.2.Patient age,primary lesion margin,shape,and TIC curve type cannot predict axillary lymph node metastasis.3.The combined prediction of peritumoral edema,maximum diameter of primary lesion,ADC value and early enhancement rate was better than the independent prediction of the four parameters.4.The comprehensive analysis of MRI features of primary breast invasive ductal carcinoma,which has a certain clinical value in predicting axillary lymph node metastasis and guiding select treatment plan.