Relationship between morphological features and kinetic patterns of enhancement of the dynamic breast magnetic resonance imaging and clinico-pathological and biological factors in invasive breast cancer

Dynamic MRI parameters of 68 invasive breast carcinomas were investigated. We also analyzed microvessel density (MVD), estrogen and progesterone receptor status, and expression of p53, HER2, ki67, VEGFR-1 and 2.Homogeneous enhancement was significantly associated with smaller tumor size (T1: < 2 cm) (p = 0.015). Tumors with irregular or spiculated margins had a significantly higher MVD than tumors with smooth margins (p = 0.038). Tumors showing a maximum enhancement peak at two minutes, or longer, after injecting the contrast, had a significantly higher MVD count than those which reached this point sooner (p = 0.012). The percentage of tumors with vascular invasion or high mitotic index was significantly higher among those showing a low percentage (≤ 150%) of maximum enhancement before two minutes than among those ones showing a high percentage (>150%) of enhancement rate (p = 0.016 and p = 0.03, respectively). However, there was a significant and positive association between the mitotic index and the peak of maximum intensity (p = 0.036). Peritumor inflammation was significantly associated with washout curve type III (p = 0.042).Variations in the early phase of dynamic MRI seem to be associated with parameters indicatives of tumor aggressiveness in breast cancer.Magnetic resonance imaging (MRI) plays an important role in the evaluation of the extent of breast cancer by revealing multifocal tumor growth in patients who are candidates for conservative breast surgery [1]. MRI permits us to explorer two concepts: First, we are able to analyze the morphologic characteristics of the lesions with high spatial resolution, such as the margin morphology (smooth, irregular or spiculated) or the internal architecture of the tumors (represented as internal mass enhancement: homogeneous, heterogeneous or rim enhancement) [1-3]. Second, we can also obtain dynamic data derived from the kinetic patterns of lesion enhancement after the administration of contrast material [4]. These