TY - JOUR
T1 - Long-term Survival in Breast Cancer Patients Is Associated with Contralateral Parenchymal Enhancement at MRI
T2 - Outcomes of the SELECT Study
AU - Ragusi, Max A.A.
AU - van der Velden, Bas H.M.
AU - Meeuwis, Carla
AU - Tetteroo, Eric
AU - Coerkamp, Emile G.
AU - van Nijnatten, Thiemo J.A.
AU - Jansen, Frits H.
AU - Wolters-Van Der Ben, Elian J.M.
AU - Jongen, Lisa
AU - van Raamt, Fleur
AU - Dorrius, Monique D.
AU - Verloop, Janneke
AU - Viergever, Max A.
AU - Pijnappel, Ruud M.
AU - Elias, Sjoerd G.
AU - Gilhuijs, Kenneth G.A.
N1 - Funding Information:
From the Department of Radiology/Image Sciences Institute (M.A.A.R., B.H.M.v.d.V., M.A.V., R.M.P., K.G.A.G.) and Department of Epidemiology, Julius Center for Health Sciences and Primary Care (S.G.E.), University Medical Center Utrecht, Utrecht University, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands; Department of Radiology, Rijnstate Hospital, Arnhem, the Netherlands (C.M.); Department of Radiology, Amphia Hospital, Breda, the Netherlands (E.T.); Department of Radiology, Haaglanden Medical Center, The Hague, the Netherlands (E.G.C.); Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands (T.J.A.v.N.); GROW School for Oncology and Reproduction, Maastricht University, Maastricht, the Netherlands (T.J.A.v.N.); Department of Radiology, Catharina Hospital, Eindhoven, the Netherlands (F.H.J.); Department of Radiology, St. Antonius Hospital, Utrecht, the Netherlands (E.J.M.W.v.d.B.); Department of Radiology, Diakonessenhuis, Utrecht, the Netherlands (L.J.); Department of Radiology, Gelre Hospital, Apeldoorn, the Netherlands (F.v.R.); Department of Radiology, University Medical Center Groningen, Groningen, the Netherlands (M.D.D.); and Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands (J.V.). Received August 3, 2022; revision requested September 7; revision received January 14, 2023; accepted February 13. Address correspondence to M.A.A.R. (email: [email protected] ). Supported by the Dutch Cancer Society (grant 10755).
Funding Information:
No relevant relationships. M.D.D. No relevant relationships. J.V. No relevant relationships. M.A.V. Honorary elections officer, Medical Image Computing and Computer-Assisted Intervention Society. R.M.P. No relevant relationships. S.G.E. No relevant relationships. K.G.A.G. Institutional grant from the Dutch Cancer Society (grant UU-2014-7151).
Publisher Copyright:
© 2023 Radiological Society of North America Inc.. All rights reserved.
PY - 2023/5
Y1 - 2023/5
N2 - Background Several single-center studies found that high contralateral parenchymal enhancement (CPE) at breast MRI was associated with improved long-term survival in patients with estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Due to varying sample sizes, population characteristics, and follow-up times, consensus of the association is currently lacking. Purpose To confirm whether CPE is associated with long-term survival in a large multicenter retrospective cohort, and to investigate if CPE is associated with endocrine therapy effectiveness. Materials and Methods This multicenter observational cohort included women with unilateral ER-positive HER2-negative breast cancer (tumor size ≤50 mm and ≤three positive lymph nodes) who underwent MRI from January 2005 to December 2010. Overall survival (OS), recurrence-free survival (RFS), and distant RFS (DRFS) were assessed. Kaplan-Meier analysis was performed to investigate differences in absolute risk after 10 years, stratified according to CPE tertile. Multivariable Cox proportional hazards regression analysis was performed to investigate whether CPE was associated with prognosis and endocrine therapy effectiveness. Results Overall, 1432 women (median age, 54 years [IQR, 47-63 years]) were included from 10 centers. Differences in absolute OS after 10 years were stratified according to CPE tertile as follows: 88.5% (95% CI: 88.1, 89.1) in tertile 1, 85.8% (95% CI: 85.2, 86.3) in tertile 2, and 85.9% (95% CI: 85.4, 86.4) in tertile 3. CPE was independently associated with OS, with a hazard ratio (HR) of 1.17 (95% CI: 1.0, 1.36;
P = .047), but was not associated with RFS (HR, 1.11;
P = .16) or DRFS (HR, 1.11;
P = .19). The effect of endocrine therapy on survival could not be accurately assessed; therefore, the association between endocrine therapy efficacy and CPE could not reliably be estimated. Conclusion High contralateral parenchymal enhancement was associated with a marginally decreased overall survival in patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative breast cancer, but was not associated with recurrence-free survival (RFS) or distant RFS. Published under a CC BY 4.0 license.
Supplemental material is available for this article. See also the editorial by Honda and Iima in this issue.
AB - Background Several single-center studies found that high contralateral parenchymal enhancement (CPE) at breast MRI was associated with improved long-term survival in patients with estrogen receptor (ER)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer. Due to varying sample sizes, population characteristics, and follow-up times, consensus of the association is currently lacking. Purpose To confirm whether CPE is associated with long-term survival in a large multicenter retrospective cohort, and to investigate if CPE is associated with endocrine therapy effectiveness. Materials and Methods This multicenter observational cohort included women with unilateral ER-positive HER2-negative breast cancer (tumor size ≤50 mm and ≤three positive lymph nodes) who underwent MRI from January 2005 to December 2010. Overall survival (OS), recurrence-free survival (RFS), and distant RFS (DRFS) were assessed. Kaplan-Meier analysis was performed to investigate differences in absolute risk after 10 years, stratified according to CPE tertile. Multivariable Cox proportional hazards regression analysis was performed to investigate whether CPE was associated with prognosis and endocrine therapy effectiveness. Results Overall, 1432 women (median age, 54 years [IQR, 47-63 years]) were included from 10 centers. Differences in absolute OS after 10 years were stratified according to CPE tertile as follows: 88.5% (95% CI: 88.1, 89.1) in tertile 1, 85.8% (95% CI: 85.2, 86.3) in tertile 2, and 85.9% (95% CI: 85.4, 86.4) in tertile 3. CPE was independently associated with OS, with a hazard ratio (HR) of 1.17 (95% CI: 1.0, 1.36;
P = .047), but was not associated with RFS (HR, 1.11;
P = .16) or DRFS (HR, 1.11;
P = .19). The effect of endocrine therapy on survival could not be accurately assessed; therefore, the association between endocrine therapy efficacy and CPE could not reliably be estimated. Conclusion High contralateral parenchymal enhancement was associated with a marginally decreased overall survival in patients with estrogen receptor-positive and human epidermal growth factor receptor 2-negative breast cancer, but was not associated with recurrence-free survival (RFS) or distant RFS. Published under a CC BY 4.0 license.
Supplemental material is available for this article. See also the editorial by Honda and Iima in this issue.
UR - http://www.scopus.com/inward/record.url?scp=85159779310&partnerID=8YFLogxK
U2 - 10.1148/radiol.221922
DO - 10.1148/radiol.221922
M3 - Article
C2 - 36975820
AN - SCOPUS:85159779310
SN - 0033-8419
VL - 307
SP - 1
EP - 8
JO - Radiology
JF - Radiology
IS - 4
M1 - e221922
ER -