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Long-term survival outcomes in invasive lobular carcinoma patients with and without preoperative MR imaging: a matched cohort study

Authors
Ha, Su MinChae, Eun YoungCha, Joo HeeKim, Hak HeeShin, Hee JungChoi, Woo Jung
Issue Date
May-2019
Publisher
SPRINGER
Keywords
Lobular carcinoma; Magnetic resonance imaging; Recurrence; Survival; Breast neoplasm
Citation
EUROPEAN RADIOLOGY, v.29, no.5, pp 2526 - 2534
Pages
9
Journal Title
EUROPEAN RADIOLOGY
Volume
29
Number
5
Start Page
2526
End Page
2534
URI
https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/44824
DOI
10.1007/s00330-018-5952-7
ISSN
0938-7994
1432-1084
Abstract
ObjectiveTo investigate and compare the effect of preoperative breast magnetic resonance (MR) imaging on recurrence-free survival (RFS) and overall survival (OS) outcomes among patients with invasive lobular carcinoma (ILC).MethodsA total of 287 ILC patients between January 2005 and December 2012 were included. One hundred twenty (41.8%) had undergone preoperative breast MR imaging (MR group) and 167 (58.2%) had not (no MR group). Two groups were matched for 21 covariates in terms of patient demographics, tumor characteristics, and clinical features. We compared unmatched variables between the patients with and without breast MR imaging using the chi-square or Student's t test. Comparisons of matched data were performed with McNemar's test or test of symmetry for categorical variables and paired t test for continuous variables. The RFS and OS outcomes were compared using the Kaplan-Meier estimates. MR effects were estimated after adjusting for significant potential confounders of specific outcomes in the multivariable modeling.ResultsIn the matched cohort, no statistically significant association was observed between MR imaging and total recurrence (hazard ratio [HR], 1.096; p=0.821), loco-regional recurrence (HR, 1.204; p=0.796), contralateral breast recurrence (HR, 0.945; p=0.952), or distant recurrence (HR, 1.020; p=0.973). MR imaging was associated with improved OS with 51% reduction, but not significantly (HR, 0.485; p=0.231). Analysis with multivariable Cox regression model indicated that MR imaging was not significant independent factor for better RFS (HR, 0.823; p=0.586) or improved OS (HR, 0.478; p=0.168).ConclusionPreoperative MR imaging is not significant prognostic factor and produces no apparent recurrence or survival outcome benefits in ILC patients.Key Points center dot Preoperative breast MR imaging in invasive lobular carcinoma was associated with a better overall survival with 51% reduction, but not statistically significant.center dot Preoperative breast MR imaging does not show significant prognostic value in invasive lobular carcinoma as there is no apparent benefit in terms of recurrence or survival outcomes.
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