Association of mammography and ultrasound features with MammaPrint in patients with estrogen receptor-positive, HER2-negative, node-positive invasive breast cancer.

ABSTRACT

BACKGROUND: MammaPrint is a 70-gene signature microarray assay that predicts the likelihood of recurrence of breast cancer and chemotherapeutic benefits. PURPOSE: To investigate the association between mammography and ultrasound (US) features and MammaPrint results in patients with estrogen receptor (ER)-positive, HER2-negative, node-positive invasive breast cancer, and to identify the predictive factors for high risk of recurrence. MATERIAL AND METHODS: This retrospective study included 251 patients with ER-positive, HER2-negative, 1-3 node-positive invasive breast cancer. Mammography and US findings were reviewed according to the BI-RADS criteria. The association between MammaPrint results and the clinicopathological and imaging features was evaluated. Logistic regression analysis was performed to identify independent predictors for high risk of recurrence. RESULTS: Of the patients, 143 (57.0%) and 108 (43.0%) had low and high risks for recurrence on MammaPrint, respectively. Young age (odds ratio [OR] 1.08; 95% confidence interval (CI) 1.04-1.12; P<0.001), posterior enhancement on US (OR 2.45; 95% CI 1.16-5.20; P = 0.019), absence of posterior shadowing on US (OR 3.19; 95% CI 1.17-8.62; P = 0.023), high histologic grade (OR 113.36; 95% CI 6.79-1893.53; P = 0.001), and high Ki-67 level (OR 4.90; 95% CI 2.62-9.17; P<0.001) were independently associated with high risk of recurrence on multivariate logistic regression analysis. CONCLUSION: Posterior features in US may predict a high risk of recurrence in patients with ER-positive, HER2-negative, node-positive invasive breast cancer, which may be useful in enhancing the diagnostic value of MammaPrint and aid in the decision-making process regarding treatment.