Abstract
To evaluate any association between tumor apparent diffusion coefficient (ADC) values and axillary lymph node metastasis (ALNM) in early-stage invasive ductal carcinoma. Records of 270 invasive ductal carcinoma patients with stages T1 and T2 disease who underwent breast magnetic resonance imaging, including diffusion-weighted imaging with b values of 0 and 1000s/mm(2) were reviewed retrospectively. The tumor ADC values were analyzed for their utility in predicting ALNM using multivariate regression analysis and receiver operating characteristic (ROC) curve analysis. Of the 270 patients, 58 (21.5%) experienced ALNM. The mean tumor ADC values were significantly lower in patients with ALNM than in those without metastasis (0.880 × 10(-3) vs. 0.999 × 10(-3)mm(2)/s, P<0.001). A ROC curve demonstrated a tumor ADC value of 0.991 × 10(-3)mm(2)/s to be the optimal cut-off for predicting ALNM. In a multivariate analysis, lower tumor ADC (≤ 0.991 × 10(-3)mm(2)/s; adjusted odds ratio (OR)=5.861, P<0.001), large tumor size (>2 cm; adjusted OR=3.156, P=0.002) and the presence of lymphovascular invasion (adjusted OR=4.125, P<0.001) were independent variables associated with ALNM. When tumor ADC value was added to known risk factors (i.e., tum...Continue Reading
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