Long-term survival outcomes in invasive lobular carcinoma patients with and without preoperative MR imaging: a matched cohort study
- 210 Downloads
To 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).
A 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.
In 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).
Preoperative MR imaging is not significant prognostic factor and produces no apparent recurrence or survival outcome benefits in ILC patients.
• Preoperative breast MR imaging in invasive lobular carcinoma was associated with a better overall survival with 51% reduction, but not statistically significant.
• 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.
KeywordsLobular carcinoma Magnetic resonance imaging Recurrence Survival Breast neoplasm
Invasive lobular carcinoma
We thank Baek, Seung Hee, a statistician who helped with the statistics.
The authors state that this work has not received any funding.
Compliance with ethical standards
The scientific guarantor of this publication is Eun Young Chae.
Conflict of interest
The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.
Statistics and biometry
Baek, Seung Hee, a statistician, kindly provided statistical advice for this manuscript.
Written informed consent was waived by the Institutional Review Board.
Institutional Review Board approval was obtained.
Study subjects or cohorts overlap
Some study subjects or cohorts have been previously reported in Radiology 2018 Jun; 287(3): 771–777 by Ha et al.
• case-control study
• performed at one institution
- 15.Ha SM, Chae EY, Cha JH, Kim HH, Shin HJ, Choi WJ (2018) Breast MR imaging before surgery: outcomes in patients with invasive lobular carcinoma by using propensity score matching. Radiology 287:771–777Google Scholar
- 16.Allred DC, Harvey JM, Berardo M, Clark GM (1998) Prognostic and predictive factors in breast cancer by immunohistochemical analysis. Mod Pathol 11:155–168Google Scholar
- 17.Edge S, Byrd DR, Compton CC, Fritz AG, Greene F, Trotti A (2011) AJCC cancer staging manual, 7th edn. Springer, BerlinGoogle Scholar