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Current Medical Imaging

Editor-in-Chief

ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

Research Article

Basal-like Breast Cancer: Comparison of Imaging Characteristics

Author(s): Bo Bae Choi*, Hyeon Ji Jang and Song I. Choi

Volume 16, Issue 3, 2020

Page: [241 - 248] Pages: 8

DOI: 10.2174/1573405615666181231162938

Price: $65

Abstract

Background: Basal-like carcinoma is one of the breast subtypes that lacks expression of the estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2). It has a poor prognosis and aggressive behavior. It is in a heterogeneous group with various other types of cancer, including metaplastic carcinoma, carcinomas with medullary features, medullary carcinoma, adenoid cystic carcinoma, secretory carcinoma, and invasive carcinoma arising in the setting of BRCA1 mutations. Imaging features of basal-like cancers have not been uniform, and there are no studies with imaging comparisons between basal-like carcinomas.

Objectives: To compare imaging features of basal-like carcinomas and to understand their characteristics.

Methods: By using our radiologic database, we retrospectively searched 37 cases of metaplastic carcinoma and 44 cases of invasive carcinoma with medullary features (ICMF). Two radiologists reviewed images according to ACR BI-RADS lexicon.

Results: The higher Ki-67 and absence of calcifications were statistically significant in ICMF than in metaplastic carcinoma. Metaplastic carcinoma demonstrated oval shape and parallel orientation more frequently. ICMF showed more irregular shape and angular margin on ultrasound, irregular or spiculated margin on breast MRI. ICMF showed more delayed washout pattern of enhancement than metaplastic carcinoma. Intratumoral T2, a very high signal was noted more in metaplastic carcinoma.

Conclusion: Our study presents variable imaging features observed between basal-like carcinomas. Although it is not sufficient to predict clinical progress, aggressiveness or prognosis of basal-like carcinomas, the results of this study will be helpful in understanding and diagnosing various basallike carcinomas.

Keywords: Breast cancers, mammography, ultrasound, magnetic resonance imaging, medullary carcinoma, triple negative breast neoplasm.

Graphical Abstract
[1]
Foulkes WD, Stefansson IM, Chappuis PO, et al. Germline BRCA1 mutations and a basal epithelial phenotype in breast cancer. J Natl Cancer Inst 2003; 95(19): 1482-5.
[http://dx.doi.org/10.1093/jnci/djg050] [PMID: 14519755]
[2]
Sotiriou C, Neo SY, McShane LM, et al. Breast cancer classification and prognosis based on gene expression profiles from a population-based study. Proc Natl Acad Sci USA 2003; 100(18): 10393-8.
[http://dx.doi.org/10.1073/pnas.1732912100] [PMID: 12917485]
[3]
Rakha EA, El-Sayed ME, Reis-Filho JS, Ellis IO. Expression profiling technology: its contribution to our understanding of breast cancer. Histopathology 2008; 52(1): 67-81.
[http://dx.doi.org/10.1111/j.1365-2559.2007.02894.x] [PMID: 18171418]
[4]
Badve S, Dabbs DJ, Schnitt SJ, et al. Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. Mod Pathol 2011; 24(2): 157-67.
[5]
Sorlie T, Perou CM, Tibshirani R, et al. Gene expression patterns of breast carcinomas distinguish tumor subclasses with clinical implications. Proc Natl Acad Sci USA 2001; 98(19): 10869-74.
[http://dx.doi.org/10.1073/pnas.191367098] [PMID: 11553815]
[6]
Sorlie T, Tibshirani R, Parker J, et al. Repeated observation of breast tumor subtypes in independent gene expression data sets. Proc Natl Acad Sci USA 2003; 100(14): 8418-23.
[http://dx.doi.org/10.1073/pnas.0932692100] [PMID: 12829800]
[7]
Weigelt B, Horlings HM, Kreike B, et al. Refinement of breast cancer classification by molecular characterization of histological special types. J Pathol 2008; 216(2): 141-50.
[http://dx.doi.org/10.1002/path.2407] [PMID: 18720457]
[8]
Kleer CG. Carcinoma of the breast with medullary-like features: diagnostic challenges and relationship with BRCA1 and EZH2 functions. Arch Pathol Lab Med 2009; 133(11): 1822-5.
[PMID: 19886718]
[9]
Kuroda N, Ohara M, Inoue K, et al. The majority of triple-negative breast cancer may correspond to basal-like carcinoma, but triple-negative breast cancer is not identical to basal-like carcinoma. Med Mol Morphol 2009; 42(2): 128-31.
[http://dx.doi.org/10.1007/s00795-008-0428-5] [PMID: 19536621]
[10]
Lae M, Freneaux P, Sastre-Garau X, Chouchane O, Sigal-Zafrani B, Vincent-Salomon A. Secretory breast carcinomas with ETV6-NTRK3 fusion gene belong to the basal-like carcinoma spectrum. Mod Pathol 2009; 22(2): 291-8.
[11]
Azoulay S, Lae M, Freneaux P, et al. KIT is highly expressed in adenoid cystic carcinoma of the breast, a basal-like carcinoma associated with a favorable outcome. Mod Pathol 2005; 18(12): 1623-31.
[12]
Gunhan-Bilgen I, Memis A, Ustun EE, Zekioglu O, Ozdemir N. Metaplastic carcinoma of the breast: clinical, mammographic, and sonographic findings with histopathologic correlation. AJR Am J Roentgenol 2002; 178(6): 1421-5.
[http://dx.doi.org/10.2214/ajr.178.6.1781421] [PMID: 12034610]
[13]
Choi BB, Shu KS. Metaplastic carcinoma of the breast: multimodality imaging and histopathologic assessment. Acta radiologica 2012; 53(1): 5-11.
[http://dx.doi.org/10.1258/ar.2011.110341]
[14]
Wargotz ES, Deos PH, Norris HJ. Metaplastic carcinomas of the breast. II. Spindle cell carcinoma. Hum Pathol 1989; 20(8): 732-40.
[http://dx.doi.org/10.1016/0046-8177(89)90065-8] [PMID: 2473024]
[15]
Rayson D, Adjei AA, Suman VJ, Wold LE, Ingle JN. Metaplastic breast cancer: prognosis and response to systemic therapy. Ann Oncol 1999; 10(4): 413-9.
[http://dx.doi.org/10.1023/A:1008329910362] [PMID: 10370783]
[16]
Jung SY, Kim HY, Nam BH, et al. Worse prognosis of metaplastic breast cancer patients than other patients with triple-negative breast cancer. Breast Cancer Res Treat 2010; 120(3): 627-37.
[http://dx.doi.org/10.1007/s10549-010-0780-8] [PMID: 20143153]
[17]
Bae SY, Lee SK, Koo MY, et al. The prognoses of metaplastic breast cancer patients compared to those of triple-negative breast cancer patients. Breast Cancer Res Treat 2011; 126(2): 471-8.
[http://dx.doi.org/10.1007/s10549-011-1359-8] [PMID: 21287362]
[18]
Harvey JA. Unusual breast cancers: useful clues to expanding the differential diagnosis. Radiology 2007; 242(3): 683-94.
[http://dx.doi.org/10.1148/radiol.2423051631] [PMID: 17325062]
[19]
Li CI. Risk of mortality by histologic type of breast cancer in the United States. Horm Cancer 2010; 1(3): 156-65.
[http://dx.doi.org/10.1007/s12672-010-0016-8] [PMID: 21761358]
[20]
Vu-Nishino H, Tavassoli FA, Ahrens WA, Haffty BG. Clinicopathologic features and long-term outcome of patients with medullary breast carcinoma managed with Breast-Conserving Therapy (BCT). Int J Radiat Oncol Biol Phys 2005; 62(4): 1040-7.
[http://dx.doi.org/10.1016/j.ijrobp.2005.01.008] [PMID: 15990007]
[21]
Miyai K, Schwartz MR, Divatia MK, et al. Adenoid cystic carcinoma of breast: Recent advances. World J Clin Cases 2014; 2(12): 732-41.
[http://dx.doi.org/10.12998/wjcc.v2.i12.732] [PMID: 25516849]
[22]
Morris EA, Comstock CE, Lee CH. ACR BI-RADS magnetic resonance imaging ACR BI-RADS atlas, breast imaging reporting and data system. Reston, VA: American College of Radiology 2013.
[23]
Elston CW, Ellis IO. Pathological prognostic factors in breast cancer. The value of histological grade in breast cancer: experience from a large study with long-term follow-up. Histopathology 1991; 19(5): 403-10.
[http://dx.doi.org/10.1111/j.1365-2559.1991.tb00229.x] [PMID: 1757079]
[24]
Kim MJ, Ro JY, Ahn SH, Kim HH, Kim SB, Gong G. Clinicopathologic significance of the basal-like subtype of breast cancer: a comparison with hormone receptor and Her2/neu-overexpressing phenotypes. Hum Pathol 2006; 37(9): 1217-26.
[http://dx.doi.org/10.1016/j.humpath.2006.04.015] [PMID: 16938528]
[25]
Badve S, Dabbs DJ, Schnitt SJ, et al. Basal-like and triple-negative breast cancers: a critical review with an emphasis on the implications for pathologists and oncologists. Modern Pathol 2011; 24(2): 157-67.
[26]
Nishimura R, Osako T, Okumura Y, Hayashi M, Toyozumi Y, Arima N. Ki-67 as a prognostic marker according to breast cancer subtype and a predictor of recurrence time in primary breast cancer. Exp Ther Med 2010; 1(5): 747-54.
[http://dx.doi.org/10.3892/etm.2010.133] [PMID: 22993598]
[27]
Wiesner FG, Magener A, Fasching PA, et al. Ki-67 as a prognostic molecular marker in routine clinical use in breast cancer patients. Breast 2009; 18(2): 135-41.
[http://dx.doi.org/10.1016/j.breast.2009.02.009] [PMID: 19342238]
[28]
Inwald EC, Klinkhammer-Schalke M, Hofstädter F, et al. Ki-67 is a prognostic parameter in breast cancer patients: results of a large population-based cohort of a cancer registry. Breast Cancer Res Treat 2013; 139(2): 539-52.
[http://dx.doi.org/10.1007/s10549-013-2560-8] [PMID: 23674192]
[29]
Uematsu T, Kasami M, Yuen S. Triple-negative breast cancer: correlation between MR imaging and pathologic findings. Radiology 2009; 250(3): 638-47.
[http://dx.doi.org/10.1148/radiol.2503081054] [PMID: 19244039]
[30]
Sung JS, Jochelson MS, Brennan S, et al. MR imaging features of triple-negative breast cancers. Breast J 2013; 19(6): 643-9.
[http://dx.doi.org/10.1111/tbj.12182] [PMID: 24015869]
[31]
Dogan BE, Gonzalez-Angulo AM, Gilcrease M, Dryden MJ, Yang WT. Multimodality imaging of triple receptor-negative tumors with mammography, ultrasound, and MRI. AJR Am J Roentgenol 2010; 194(4): 1160-6.
[http://dx.doi.org/10.2214/AJR.09.2355] [PMID: 20308526]
[32]
Meyer JE, Amin E, Lindfors KK, Lipman JC, Stomper PC, Genest D. Medullary carcinoma of the breast: mammographic and US appearance. Radiology 1989; 170(1 Pt 1): 79-82.
[http://dx.doi.org/10.1148/radiology.170.1.2642350] [PMID: 2642350]
[33]
Cho N, Oh KK, Lee SI. Medullary carcinoma of the breast: sonographic features distinguishing it from fibroadenoma. J Med Ultrasound 2002; 10(4): 191-6.
[http://dx.doi.org/10.1016/S0929-6441(09)60035-7]
[34]
Dietzel M, Zoubi R, Vag T, et al. Association between survival in patients with primary invasive breast cancer and computer aided MRI. J Magn Reson Imaging 2013; 37(1): 146-55.
[http://dx.doi.org/10.1002/jmri.23812] [PMID: 23011784]
[35]
Schnall MD, Blume J, Bluemke DA, et al. Diagnostic architectural and dynamic features at breast MR imaging: multicenter study. Radiology 2006; 238(1): 42-53.
[http://dx.doi.org/10.1148/radiol.2381042117] [PMID: 16373758]
[36]
Osman NM, Chalabi N, Raboh NMA. Triple negative breast cancer: MRI features in comparison to other breast cancer subtypes with correlation to prognostic pathologic factors. EJRNM 2014; 45(4): 1309-16.
[http://dx.doi.org/10.1016/j.ejrnm.2014.07.002]
[37]
Chen JH, Agrawal G, Feig B, et al. Triple-negative breast cancer: MRI features in 29 patients. Ann Oncol 2007; 18(12): 2042-3.
[http://dx.doi.org/10.1093/annonc/mdm504] [PMID: 18029970]
[38]
Tabar L, Chen HH, Duffy SW, et al. A novel method for prediction of long-term outcome of women with T1a, T1b, and 10-14 mm invasive breast cancers: a prospective study. Lancet 2000; 355(9202): 429-33.
[http://dx.doi.org/10.1016/S0140-6736(00)82008-5] [PMID: 10841122]
[39]
Shin SU, Lee J, Kim JH, et al. Gene expression profiling of calcifications in breast cancer. Sci Rep 2017; 7(1): 11427.
[http://dx.doi.org/10.1038/s41598-017-11331-9] [PMID: 28900139]
[40]
Bae MS, Moon WK, Chang JM, et al. Mammographic features of calcifications in DCIS: correlation with oestrogen receptor and human epidermal growth factor receptor 2 status. Eur Radiol 2013; 23(8): 2072-8.
[http://dx.doi.org/10.1007/s00330-013-2827-9] [PMID: 23512196]
[41]
Seo BK, Pisano ED, Kuzimak CM, et al. Correlation of HER-2/neu overexpression with mammography and age distribution in primary breast carcinomas. Acad Radiol 2006; 13(10): 1211-8.
[http://dx.doi.org/10.1016/j.acra.2006.06.015] [PMID: 16979070]
[42]
Krizmanich-Conniff KM, Paramagul C, Patterson SK, et al. Triple receptor-negative breast cancer: imaging and clinical characteristics. AJR Am J Roentgenol 2012; 199(2): 458-64.
[http://dx.doi.org/10.2214/AJR.10.6096] [PMID: 22826413]
[43]
Gao B, Zhang H, Zhang SD, et al. Mammographic and clinicopathological features of triple-negative breast cancer. Br J Radiol 2014; 87(1039): 20130496.44.
[http://dx.doi.org/10.1259/bjr.20130496] [PMID: 24734934]
[44]
Yang WT, Dryden M, Broglio K, et al. Mammographic features of triple receptor-negative primary breast cancers in young premenopausal women. Breast Cancer Res Treat 2008; 111(3): 405-10.
[http://dx.doi.org/10.1007/s10549-007-9810-6] [PMID: 18026834]
[45]
Ko ES, Lee BH, Kim HA, Noh WC, Kim MS, Lee SA. Triple-negative breast cancer: correlation between imaging and pathological findings. Eur Radiol 2010; 20(5): 1111-7.
[http://dx.doi.org/10.1007/s00330-009-1656-3] [PMID: 19898850]

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