Edema scores can help predict the aggressiveness of breast cancer
Higher breast edema scores derived from MRI exams could be indicative of more aggressive cancer, a new study suggests.
Researchers recently discovered strong associations between the type and amount of breast edema a patient has on preoperative MRI and whether they will go on to develop lymph node metastasis. Specifically, the paper, published in Clinical Radiology, noted that certain classifications of edema, defined by a specific score, visualized on T2-weighted imaging are an independent risk factor for cancer that will metastasize and is a greater predictor of this than standard clinicopathological models alone.
It has been well established that breast edema on imaging is often linked with a cancer’s aggressiveness, but the authors of this study suggested that more thoroughly classifying edema could provide a more accurate idea of how a cancer might spread.
“Breast edema has been studied as a critical predictor associated with the outcome of patients with invasive breast cancer,” corresponding author Yunfeng Zhou, from the department of radiology at Yijishan Hospital of Wannan Medical College in China, and colleagues explained. “However, these studies did not always separate these various types of breast edema or examine the relationship between each type and sentinel lymph node metastasis.”
The team graded breast edema seen on the MRI exams of 341 women on a 4-point scale (1, no edema; 2, peritumoral edema; 3, prepectoral edema; and 4, subcutaneous edema), with a score of 1 representing the lowest end of the scale and 4 indicating the most serious findings. The scores were compared to a clinicopathological model that included other risk factors, but not edema scores, before being combined with the model for an additional analysis.
Though edema scores alone were an independent risk factor of metastases, the combined model significantly improved the predictive performance. Further, edema scores were also found to have a positive correlation with tumor diameter, histologic grade, Ki-67 index and non-luminal subtypes.
Authors of the study suggested that their findings warrant the inclusion of a description of breast edema classification in breast MRI reports.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.