Triple-neg breast cancer less likely to come back following preoperative MRI

When it comes to reducing the risk of recurrence in patients with triple-negative breast cancers, pre-op MRI may be just what the doctor ordered.

The suggestion comes from a retrospective study of 398 patients who had surgery to resect the hard-to-treat cancer. Those who did not have the imaging were substantially more likely to have recurrence than those who did.

“Triple Neg” does not respond to hormonal therapies or other interventions that target the hormone epidermal growth factor receptor 2 (HER-2) protein receptor. It gets its nickname from the cancer cells’ testing negative for receptors of three molecules—HER-2, estrogen and progesterone.

Researchers from the radiology and pathology departments at Seoul National University Hospital in Korea looked mostly at triple-negative invasive ductal carcinomas (393 of the 398 cases they reviewed). Of these, 346 (86.9 percent) were high-grade tumors and 85 (21.4 percent) showed axillary lymph node involvement.

During the study period, all patients underwent either breast conservation surgery (292 patients, 73.4 percent) or mastectomy (106 patients, 26.6 percent).

Of 63 patients whose breast cancer recurred after surgery, more than a quarter—16 patients, or 25.4 percent—had not been imaged with MR prior to the surgery (hazard ratio at multivariate analysis = 2.66).

Other factors were also at play. Most notably, some 53 (84.1 percent) of those whose cancers came back after surgery had dense breast tissue (hazard ratio = 2.77).

Eight of these patients, 12.7 percent, had a family history of breast cancer (hazard ratio = 2.32).

RSNA has released the study ahead of print in Radiology.

The authors state that a strength of their study was that the patient population reviewed was both relatively homogeneous in cancer stage and similarly treated with cancer therapies.

“Our study suggests that preoperative MR imaging may help reduce the risk of recurrence in patients with triple-negative breast cancers,” they write. “Prospective studies are warranted to investigate the benefit of preoperative MR imaging in patients with triple-negative breast cancer.”

Click here to read the full study.