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Breast Cancer

, Volume 25, Issue 4, pp 456–463 | Cite as

Preoperative breast MRI: reproducibility and significance of findings relevant to nipple–areolar complex involvement

  • Youichi Machida
  • Akiko Shimauchi
  • Takao Igarashi
  • Kazuei Hoshi
  • Eisuke Fukuma
Original Article
  • 108 Downloads

Abstract

Background

Eligibility of nipple-sparing mastectomy has been expanded. The purpose of this study was to evaluate interobserver agreement regarding magnetic resonance imaging (MRI) descriptors important in determining eligibility for mastectomy, and to investigate the significance of enhancement extending to the areola concerning nipple–areolar complex (NAC) involvement.

Methods

Fifty-one cases with histologically confirmed NAC involvement and 54 cases with negative NAC were enrolled. Two radiologists assessed the following factors: lesion morphology (mass or non-mass enhancement); intra-nipple bright signal; enhancement extending to the areola; abnormal nipple enhancement; and tumor–nipple distance. Factors that showed a significant association with outcome in the univariate analysis were assessed by means of multivariate analysis using a logistic regression model. Interobserver agreement between observers was assessed by calculating κ values (dichotomous variables), or intraclass correlation coefficients (ICCs; continuous variables).

Results

In multivariate analysis of the results from the two observers, tumor–nipple distance (observer 1: odds ratio [OR] 0.93; 95% confidence interval [CI] 0.88–0.99; observer 2: OR 0.89; 95% CI 0.83–0.95) and enhancement extending to the areola (observer 1: OR 17.9; 95% CI 1.97–162.2; observer 2: OR 24.0; 95% CI 2.62–219.7) were found to be significant predictors of NAC involvement. A substantial agreement (κ = 0.64–0.71) for every dichotomous variable and an almost perfect agreement (ICC = 0.86) for continuous variable were observed.

Conclusions

Findings of breast MRI for NAC preservation had good interobserver agreement. Enhancement extending to the areola, together with tumor–nipple distance, was significant factors for NAC involvement.

Keywords

Breast cancer Magnetic resonance imaging Nipple–areolar complex Nipple-sparing mastectomy Interobserver agreement 

Notes

Acknowledgements

This study was presented at the 24th Annual Meeting of the Japanese Breast Cancer Society, Fukuoka, July 13–15, 2017 (Presentation No. OS-1-01-04).

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest.

Supplementary material

12282_2018_845_MOESM1_ESM.tif (84 mb)
Supplementary material 1 (TIFF 86029 kb) Supplemental Fig. 1 The enrollment criteria. Primary systemic therapy was not performed, and no locoregional recurrence or metastasis was detected for ≥ 2 years after surgical treatment, in eligible cases. Bt, total mastectomy; NAC, nipple–areolar complex; NSM, nipple-sparing mastectomy; SSM, skin-sparing mastectomy
12282_2018_845_MOESM2_ESM.tif (84.9 mb)
Supplementary material 2 (TIFF 86943 kb) Supplemental Fig. 2 Receiver operating characteristic (ROC) curves of tumor–nipple distance, for the prediction of nipple–areolar complex involvement
12282_2018_845_MOESM3_ESM.tif (2.5 mb)
Supplementary material 3 (TIFF 2588 kb) Supplemental Fig. 3: Receiver operating characteristic (ROC) curves of tumor–nipple distance of 5 mm and enhancement attached to the areolar, for the prediction of nipple–areolar complex involvement

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Copyright information

© The Japanese Breast Cancer Society 2018

Authors and Affiliations

  • Youichi Machida
    • 1
    • 2
  • Akiko Shimauchi
    • 1
  • Takao Igarashi
    • 3
  • Kazuei Hoshi
    • 4
  • Eisuke Fukuma
    • 2
  1. 1.RadiologyKameda Kyobashi ClinicTokyoJapan
  2. 2.Breast Center, Kameda Medical CenterKamogawaJapan
  3. 3.Department of Diagnostic ImagingJikei University School of Medicine HospitalTokyoJapan
  4. 4.Anatomic PathologyKameda Medical CenterKamogawaJapan

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