Correlation Between MRI and the Level of Tumor-Infiltrating Lymphocytes in Patients With Triple-Negative Breast Cancer.

ABSTRACT

OBJECTIVE: Increased levels of tumor-infiltrating lymphocytes (TILs) positively correlate with the pathologic complete response rate and increased survival in patients with triple-negative breast cancer (TNBC). The purpose of this study was to investigate associations between TIL levels and MRI findings in patients with TNBC. MATERIALS AND METHODS: From February 2006 through December 2014, a total of 112 women with TNBC were selected for inclusion in the study. All lesions were evaluated by radiologists in accordance with the BI-RADS lexicon. Lymph node involvement and multifocality were also assessed. Tumors were divided into two groups those with a TIL level of less than 50% were included in the group with low TIL levels (hereafter referred to as the "low-TIL group"), and those with a TIL level of 50% or more were included in the group with high TIL levels (hereafter referred to as the "high-TIL group"). Associations between TIL levels and imaging features were evaluated. RESULTS: Tumors in the high-TIL group had a more round shape (46.0%), a circumscribed margin (76.0%), homogeneous enhancement (32.0%), and absence of multifocality (88.0%) (p < 0.005). Tumors in the low-TIL group had a more irregular shape (69.3%), no circumscribed margin (79.0%), heterogeneous enhancement (75.8%), and multifocality (70.9%) (p < 0.005). CONCLUSION: The well-known typical features of TNBC on MRI, including a round shape, a circumscribed margin, homogeneous enhancement, and lack of multifocality, are a major pattern of TNBC with high TIL levels. This information could provide added diagnostic benefit for the identification of tumors with a good prognosis, which could further assist in optimal pretreatment planning.