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Abstract：
Background Human epidermal growth factor receptor 2-positive (HER2+) breast cancer has two distinct subtypes according to hormone receptor (HR) status. Survival, pattern of recurrence, and treatment response differ between HR-/HER2+ and HR+/HER2+ cancers. Purpose To investigate imaging and clinicopathologic features of HER2+ cancers and their correlation with HR expression. Material and Methods Between 2011 and 2013, 252 consecutive patients with 252 surgically confirmed HER2+ cancers (125 HR- and 127 HR+) were included. Two experienced breast radiologists blinded to the clinicopathologic findings reviewed the mammograms and magnetic resonance (MR) images using the BI-RADS lexicon. Tumor kinetic features were acquired by computer-aided detection (CAD). The imaging and clinicopathologic features of 125 HR-/HER2+ cancers were compared with those of 127 HR+/HER2+ cancers. Association between the HR status and each feature was assessed. Results Multiple logistic regression analysis showed that circumscribed mass margin (odds ratio [OR], 4.73; P < 0.001), associated non-mass enhancement (NME) on MR images (OR, 3.29; P = 0.001), high histologic grade (OR, 3.89; P = 0.002), high Ki-67 index (OR, 3.06; P = 0.003), and older age (OR, 2.43; P = 0.006) remained independent indicators associated with HR-/HER2+ cancers. Between the two HER2+ subtypes, there were no differences in mammographic imaging presentations and calcification features and MR kinetic features by a CAD. Conclusion HER2+ breast cancers have different MR imaging (MRI) phenotypes and clinicopathologic feature according to HR status. MRI features related to HR and HER2 status have the potential to be used for the diagnosis and treatment decisions in HER2+ breast cancer patients.
摘要：
背景根据激素受体(HR)状态,人类表皮生长因子受体2阳性(HER2+)乳腺癌具有两种不同的亚型。生存,复发模式，HR-/HER2+和HR+/HER2+癌症之间的治疗反应不同。目的探讨HER2+癌的影像学、临床病理特征及其与HR表达的相关性。材料与方法2011年至2013年，共纳入252例经手术证实的HER2+癌症患者（125HR-和127HR+）。两名经验丰富的乳腺放射科医生对临床病理结果视而不见，使用BI-RADS词典回顾了乳房X线照片和磁共振（MR）图像。通过计算机辅助检测(CAD)获得肿瘤动力学特征。比较了125例HR-/HER2+癌症与127例HR+/HER2+癌症的影像学和临床病理特征。评估HR状态和每个特征之间的关联。结果多元logistic回归分析显示，界限质量边缘(比值比[OR]，4.73；P<0.001），MR图像上的相关非质量增强(NME)(或，3.29；P=0.001），组织学分级高（OR，3.89；P=0.002），高Ki-67指数(OR，3.06；P=0.003），年龄较大（或，2.43；P=0.006）仍然是与HR-/HER2+癌症相关的独立指标。在两种HER2+亚型之间，CAD在乳腺X线摄影成像表现、钙化特征和MR动力学特征方面没有差异.结论HER2+乳腺癌根据HR状态有不同的磁共振成像(MRI)表型和临床病理特征。与HR和HER2状态相关的MRI特征有可能用于HER2+乳腺癌患者的诊断和治疗决策。
