Background

Background parenchymal enhancement (BPE) is a known risk factor for breast cancer. However, studies on the association between BPE and second breast cancer risk are still lacking.

Purpose

To investigate whether BPE at surveillance breast MRI is associated with subsequent second breast cancer risk in women with a personal history of breast cancer.

Materials and Methods

A retrospective search of the imaging database of an academic medical center identified consecutive surveillance breast MRI examinations performed between January 2008 and December 2017 in women who underwent surgery for primary breast cancer and had no prior diagnosis of second breast cancer. BPE at surveillance breast MRI was qualitatively assessed using a four-category classification of minimal, mild, moderate, or marked. Future second breast cancer was defined as ipsilateral breast tumor recurrence or contralateral breast cancer diagnosed at least 1 year after each surveillance breast MRI examination. Factors associated with future second breast cancer risk were evaluated using the multivariable Fine-Gray subdistribution hazard model.

Results

Among the 2668 women (mean age at baseline surveillance breast MRI, 49 years ± 8 [SD]), 109 developed a second breast cancer (49 ipsilateral, 58 contralateral, and two ipsilateral and contralateral) at a median follow-up of 5.8 years. Mild, moderate, or marked BPE at surveillance breast MRI (hazard ratio [HR], 2.1 [95% CI: 1.4, 3.1]; P < .001), young age (<45 years) at initial breast cancer diagnosis (HR, 3.4 [95% CI: 1.7, 6.4]; P < .001), positive results from a BRCA1/2 genetic test (HR, 6.5 [95% CI: 3.5, 12.0]; P < .001), and negative hormone receptor expression in the initial breast cancer (HR, 1.6 [95% CI: 1.1, 2.6]; P = .02) were independently associated with an increased risk of future second breast cancer.

Conclusion

Background parenchymal enhancement at surveillance breast MRI was associated with future second breast cancer risk in women with a personal history of breast cancer.

© RSNA, 2022

Online supplemental material is available for this article.

See also the editorial by Niell in this issue.

中文翻译：

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背景 术后监测乳腺 MRI 的实质增强：与未来二次乳腺癌风险的关联

背景

背景实质增强 (BPE) 是乳腺癌的已知危险因素。然而，仍然缺乏关于 BPE 与第二乳腺癌风险之间关联的研究。

目的

调查监测乳房 MRI 时的 BPE 是否与有乳腺癌个人病史的女性随后的第二次乳腺癌风险相关。

材料和方法

对学术医学中心影像数据库的回顾性搜索确定了在 2008 年 1 月至 2017 年 12 月期间对接受过原发性乳腺癌手术且之前未诊断出第二乳腺癌的女性进行的连续监测乳腺 MRI 检查。使用最小、轻度、中度或明显的四类分类对监测乳房 MRI 的 BPE 进行定性评估。未来的第二个乳腺癌被定义为同侧乳腺肿瘤复发或在每次监测乳腺 MRI 检查后至少 1 年诊断出对侧乳腺癌。使用多变量 Fine-Gray 子分布风险模型评估与未来第二次乳腺癌风险相关的因素。

结果

在 2668 名女性（基线监测乳房 MRI 时的平均年龄，49 ± 8 [SD]）中，109 名在中位随访 5.8 年时发展为第二个乳腺癌（同侧 49 名，对侧 58 名，同侧和对侧各 2 名） . 监测乳腺 MRI 时出现轻度、中度或显着 BPE（风险比 [HR]，2.1 [95% CI：1.4，3.1]；P < .001），初诊乳腺癌时年龄较小（<45 岁）（HR， 3.4 [95% CI: 1.7, 6.4]; P < .001)，BRCA1/2基因检测阳性结果（HR, 6.5 [95% CI: 3.5, 12.0]; P < .001），激素受体阴性在初始乳腺癌中的表达 (HR, 1.6 [95% CI: 1.1, 2.6]; P= .02) 与未来二次乳腺癌风险增加独立相关。

结论

监测乳房 MRI 时的背景实质增强与有乳腺癌个人病史的女性未来患第二次乳腺癌的风险相关。

©北美放射学会，2022

本文提供了在线补充材料。

另请参阅本期 Niell 的社论。