European Radiology

, Volume 29, Issue 12, pp 7000–7008 | Cite as

Can enhancement types on preoperative MRI reflect prognostic factors and surgical outcomes in invasive breast cancer?

  • Jieun Koh
  • Ah Young Park
  • Kyung Hee Ko
  • Hae Kyoung JungEmail author



This study was conducted in order to evaluate whether enhancement types on preoperative MRI can reflect prognostic factors and surgical outcomes in invasive breast cancer.


Among 484 consecutive patients who underwent preoperative breast MRI from October 2014 to July 2017 for biopsy-proven breast cancer, 313 patients with 315 invasive breast cancers who underwent subsequent surgery were finally included in this study. Two radiologists retrospectively reviewed preoperative MRI findings of these 315 lesions and categorized them to mass, nonmass, and combined type according to enhancement features. Combined type was defined as coexisted mass and nonmass enhancement. Histopathologic results focusing on prognostic factors and surgical outcomes were compared among the three types of lesion using Pearson’s chi-square, linear-by-linear association, Kruskal–Wallis, one-way ANOVA test, and multinomial logistic regression.


Of the cancers analyzed, 198 (62.9%) were mass, 59 (18.7%) were nonmass, and 58 (18.4%) were combined type. The nonmass type showed the smallest invasive tumor size (p < 0.001) and the most common positive HER2 receptor status (p = 0.001). The combined type had the most frequent lymphovascular invasion (p = 0.011), axillary lymph node–positive status (p = 0.031), operation changes (p < 0.001), and first resection margin–positive status (p < 0.001). Initial operation of mastectomy was more frequent in the nonmass and combined types than that in the mass type (p < 0.001). But HER2 receptor status and operation changes showed no statistical significance on multivariate analysis.


Enhancement types on preoperative MRI reflect different prognostic factors and surgical outcomes in invasive breast cancer.

Key Points

• Morphologic features of contrast media uptake on contrast-enhanced MRI may be related with fundamental biological differences of invasive breast cancers.

• Mass or nonmass enhancement type on preoperative MRI might reflect different prognostic factors and surgical outcomes in invasive breast cancer.

• The combined mass and nonmass enhancement type might be associated with poorer prognosis and worse surgical outcomes.


Magnetic resonance imaging Breast neoplasms Prognosis Surgical oncology 



American Joint Committee on Cancer


Breast-conserving surgery


Ductal carcinoma in situ


Estrogen receptor


Human epidermal growth factor receptor 2


Invasive ductal cancer




Lymphovascular invasion


Mass enhancement


Magnetic resonance imaging


Nonmass enhancement


Progesterone receptor



The authors state that this work has not received any funding.

Compliance with ethical standards


The scientific guarantor of this publication is Hae Kyoung Jung.

Conflict of interest

The authors declare that they have no conflict of interest.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.


• retrospective

• observational

• performed at one institution


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Copyright information

© European Society of Radiology 2019

Authors and Affiliations

  • Jieun Koh
    • 1
  • Ah Young Park
    • 1
  • Kyung Hee Ko
    • 1
  • Hae Kyoung Jung
    • 1
    Email author
  1. 1.Department of Radiology, CHA Bundang Medical Center, School of MedicineCHA UniversitySeongnamSouth Korea

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