Preoperative Predictors of Subsequent Breast Cancer Events Detected on Abbreviated MRI in Patients with Early-Stage Breast Cancer

Abstract

Background/Objectives: This study aimed to investigate the preoperative clinicopathologic and imaging features associated with subsequent breast cancer events detected on postoperative abbreviated MRI in early-stage breast cancer patients following breast and axillary surgery. Methods: A retrospective analysis was conducted on 1171 patients (median age, 53 years; range, 24-90 years) diagnosed with clinical stage I or II breast cancer between January 2013 and December 2017. Logistic regression analysis was used to evaluate preoperative imaging features-including breast density assessed on mammography and MRI descriptors-along with clinicopathologic characteristics, to identify factors independently associated with subsequent breast cancer events during abbreviated MRI screening. Results: Among the patients, 57 (4.9%) experienced subsequent breast cancer events at a median follow-up of 74 months. In the multivariable analysis, high nuclear grade (odds ratio [OR] = 2.821; 95% confidence interval [CI], 1.427-5.577; p = 0.003), dense breast tissue on mammography (OR = 4.680; 95% CI, 1.113-19.684; p = 0.035), and absence of heterogeneous internal enhancement on preoperative MRI (OR = 0.429; 95% CI, 0.206-0.891; p = 0.023) were independently associated with subsequent breast cancer events detected using an abbreviated breast MRI protocol. Age ≥ 40 years (OR = 0.448; 95% CI, 0.193-1.039; p = 0.061) and clinical T2 stage (OR = 1.744; 95% CI, 0.969-3.139; p = 0.064) showed borderline significance. Conclusions: High nuclear grade, dense breast tissue on mammography, and absence of heterogeneous internal enhancement on preoperative MRI were associated with an increased risk of subsequent breast cancer events in patients undergoing abbreviated MRI surveillance following surgery for early-stage breast cancer.