TITLE:
Pre-Operative MRI in HER-2 Receptor Positive and Her-2 Receptor Negative Breast Cancer: A Comparison
AUTHORS:
Ashwini Sharma
KEYWORDS:
Breast MRI, Herceptin Receptor Positive Breast Cancer, Pathological Size Correlation
JOURNAL NAME:
Advances in Breast Cancer Research,
Vol.12 No.2,
April
27,
2023
ABSTRACT: Objectives: MRI is the most sensitive modality for local
staging of breast cancer. Herceptin receptor
over-expression is seen in 15% - 30% of breast tumours, and is associated with increased aggression, poorer
prognosis, higher grade at diagnosis and increased lymphatic dissemination.
This study aimed at evaluating the role of MRI in Herceptin receptor positive
vs negative tumours. Methods: 193 pre-operative MRIs were performed in
2021 for staging of 162 Her-2 negative and 37 Her-2 positive tumours. Recall
rates and further biopsies (ipsilateral/contralateral) were assessed in both
groups, and MRI largest size was compared to pathological size of invasive cancer
and DCIS. Results: 36.4% of Her-2 negative tumours were recalled;
further ipsilateral malignancy was identified in 13.6%. Contralateral
malignancy was identified in 1.2%. 29.7% of Her-2 positive tumours were
recalled; further ipsilateral malignancy was identified in 16.2%. No contralateral
malignancy was seen in Her-2 positive tumours. The OR of Her-2 positive tumours
having ipsilateral foci of malignancy on MRI is 0.83 (CI 0.3, 2.2). Pathological
size concordance with MRI size was seen in 70.3% of Her-2 negative, and 48.6%
of Her-2 positive tumours. Discordance in both groups was due to MRI size
overestimation (70.8% of Her-2 negative
discordance; 89.4% of Her-2 positive discordance). Conclusions: Pre-operative
MRI did not detect significant increased additional foci in Her-2 positive
tumours. Significant concordance with pathological size was not seen in both
groups; MRI overestimation was the most frequent cause for discordance in both
groups. Advances in Knowledge: This study compares MRI features
of Her-2 positive and Her-2 negative tumours. It demonstrates that there is no
significant increased multifocality or multicentricity of Her-2 positive
tumours, but MRI over-estimates size in 30% of Her-2 negative and 51% of Her-2
positive cancers.