MRI Background Parenchymal Enhancement as a Risk Factor for Breast Cancer

MRI 背景实质增强是乳腺癌的危险因素

• 批准号: 9108312
• 负责人: JONINE L. BERNSTEIN
• 金额: $ 68.25万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-08-01 至 2018-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9108312
• 关键词: Age; American College of Radiology; Area; Blinded; Breast; Breast Cancer Detection; Breast Cancer Patient; Breast Cancer Risk Factor; Case-Control Studies; Categories; Characteristics; Classification; Clinical; Clinical Data; Clinical Management; Clinical Research; Computerized Medical Record; Computers; Contrast Media; Diagnosis; Epidemiology; Ethnic Origin; Goals; Health; High Risk Woman; Hospitals; Information Systems; Interview; Joints; Magnetic Resonance Imaging; Malignant Neoplasms; Mammary Gland Parenchyma; Mammographic Density; Mammography; Measures; Medical Records; Memorial Sloan-Kettering Cancer Center; Menopausal Status; Methods; Modeling; Participant; Patient-Focused Outcomes; Phase; Preventive Intervention; Preventive measure; Quality Control; Questionnaires; Race; Reader; Recruitment Activity; Reporting; Research; Risk; Risk Assessment; Risk Estimate; Risk Factors; Running; Staging; Subgroup; Telephone Interviews; Time; Tissues; Woman; abstracting; base; breast imaging; cancer risk; computerized; contrast enhanced; density; follow-up; high risk; improved; malignant breast neoplasm; novel; screening; tool; tumor

DESCRIPTION (provided by applicant): Contrast-enhanced breast magnetic resonance imaging (MRI) is a clinically useful tool for breast cancer screening in high-risk women and the diagnosis, staging, and clinical management of breast cancer patients, and may also have utility in the determination of breast cancer risk. Normal breast fibroglandular tissue (FGT), which appears white on mammography (i.e. mammographic density (MD)), is a well-established risk factor for breast cancer. FGT is also visible on breast MRI (MRI-FGT) and enhances (becomes brighter) to varying extents after administration of MRI-contrast medium. Background parenchymal enhancement (MRI-BPE) is a measure of the volume and intensity of this enhancement. In a study of 39 breast cancer cases and 78 cancer- free controls undergoing breast screening with MRI, MRI-BPE was strongly associated with breast cancer risk; women in the highest MRI-BPE category had a 7.5-fold higher risk of breast cancer compared with those in the lowest MRI-BPE groups. MRI-BPE only weakly correlated with MRI-FGT, which is strongly correlated with MD, indicating that MRI-BPE may be an independent marker of breast cancer risk. We propose to confirm these findings by conducting a multi-center, hospital-based, case-control study examining MRI-BPE and MRI-FGT as markers of breast cancer risk. Across three centers we will recruit, interview, and collect medical records and pre-treatment MRIs and mammograms from 1,110 women with invasive breast cancer (cases) and 1,110 high- risk women who are cancer-free and are undergoing MRI breast cancer screening (controls). Clinical data and tumor characteristics (for cases) will be abstracted through electronic medical record review. MRI-BPE and MRI-FGT will be scored by a single reader using standard clinical measures and mammographic percent density (MPD) using Cumulus. We also propose to measure both MRI-BPE and MRI-FGT using a new fully automated method. Our hypothesis is that while MRI-FGT and MPD measure the amount of FGT, MRI-BPE is a marker of breast tissue activity, contributing to breast cancer risk independently of the amount of FGT present. Our Primary Aim is to examine the relationship between MRI-BPE and MRI-FGT measured by Breast Imaging-Reporting and Data System (BI-RADS) categories, and breast cancer risk. Our Secondary Aims are: 1) to determine whether the inclusion of MRI-BPE improves breast cancer risk assessment over that achieved by MPD alone; and 2) to examine the association between MRI-BPE and MRI-FGT, measured on a continuous scale by a novel automated computerized method, and breast cancer risk. In the long-run MRI-BPE could greatly improve the accuracy of breast cancer risk prediction among high-risk women undergoing breast MRI screening by identifying a subgroup of women who would benefit the most from heightened screening and preventive measures and possibly a subgroup of women at lower risk who may benefit from less intensive screening. The automated quantitative measures of MRI-BPE and MRI-FGT would greatly facilitate the incorporation of these measures into widespread clinical and research practice.

描述（由申请人提供）：对比增强的乳腺磁共振成像（MRI）是一种临床上有用的工具，可用于乳腺癌妇女的乳腺癌筛查以及对乳腺癌患者的诊断，分期和临床管理，并且在确定乳腺癌风险方面也可能具有实用性。正常的乳腺纤维结构组织（FGT）在乳房X线摄影（即乳腺X线摄影密度（MD））上出现是乳腺癌的危险因素。 FGT在乳房MRI（MRI-FGT）上也可见，并且在使用MRI对比度培养基后会增强（变得更明亮）。背景实质增强（MRI-BPE）是该增强体积和强度的量度。在一项针对39例乳腺癌病例和78种通过MRI乳房筛查的癌症的自由对照的研究中，MRI-BPE与乳腺癌风险密切相关。与最低的MRI-BPE组相比，MRI-BPE类别中最高的女性患乳腺癌风险高7.5倍。 MRI-BPE仅与MRI-FGT弱相关，MRI-FGT与MD密切相关，表明MRI-BPE可能是乳腺癌风险的独立标志。我们建议通过进行多中心的，基于医院的病例对照研究来确认这些发现，该研究检查MRI-BPE和MRI-FGT作为乳腺癌风险的标志。在三个中心，我们将招募，访谈和收集从1,110名侵入性乳腺癌（病例）和1,110名没有癌症且正在进行MRI乳腺癌筛查（对照组）的高风险女性的女性（病例）和1,110名高风险女性（对照）中的病历和乳房X线照片。临床数据和肿瘤特征（对于病例）将通过电子病历审查提取。 MRI-BPE和MRI-FGT将使用标准临床测量和使用Cumulus的标准临床措施和乳房X线摄影百分比（MPD）对单个阅读器进行评分。我们还建议使用新的全自动方法测量MRI-BPE和MRI-FGT。我们的假设是，尽管MRI-FGT和MPD测量了FGT的量，但MRI-BPE是乳腺组织活性的标志，与乳腺癌的风险无关，而与存在的FGT量无关。我们的主要目的是检查MRI-BPE与MRI-FGT之间通过乳房成像报告和数据系统（BI-RADS）类别和乳腺癌风险测量的关系。我们的次要目的是：1）确定纳入MRI-BPE是否可以改善单独使用MPD的乳腺癌风险评估； 2）检查MRI-BPE和MRI-FGT之间的关联，并通过一种新型的自动化计算机化方法和乳腺癌风险以连续的量表进行测量。在长期的MRI-BPE中，通过确定一群受益于筛查和预防措施的较高的妇女，可能受益最大的妇女，以及可能受益于较低强度较低的筛查，他们可能会受益于较低的妇女，从而极大地提高了接受乳腺MRI筛查的高风险预测的准确性。 MRI-BPE和MRI-FGT的自动定量度量将极大地促进这些措施纳入广泛的临床和研究实践。

项目成果

Histopathologic characteristics of background parenchymal enhancement (BPE) on breast MRI.

• DOI: 10.1007/s10549-018-4916-6
• 发表时间: 2018-11
• 期刊: Breast cancer research and treatment
• 影响因子: 3.8
• 作者: Sung JS;Corben AD;Brooks JD;Edelweiss M;Keating DM;Lin C;Morris EA;Patel P;Robson M;Woods M;Bernstein JL;Pike MC
• 通讯作者: Pike MC

Association of breast cancer with MRI background parenchymal enhancement: the IMAGINE case-control study.

• DOI: 10.1186/s13058-020-01375-7
• 发表时间: 2020-12-07
• 期刊: Breast cancer research : BCR
• 作者: Watt GP;Sung J;Morris EA;Buys SS;Bradbury AR;Brooks JD;Conant EF;Weinstein SP;Kontos D;Woods M;Colonna SV;Liang X;Stein MA;Pike MC;Bernstein JL
• 通讯作者: Bernstein JL