Mammography, US, and MRI to Assess Outcomes of Invasive Breast Cancer with Extensive Intraductal Component: A Matched Cohort Study

Background An extensive intraductal component (EIC) in breast cancer is an independent risk factor for local recurrence after surgery, especially in young, premenopausal women. Few studies have analyzed long-term outcomes or imaging features of EIC-positive breast cancer. Purpose To assess the prognostic value of EIC on recurrence-free and overall survival in breast cancer and evaluate imaging features of EIC-positive breast cancer by using mammography, US, and MRI. Materials and Methods A retrospective study of 6816 consecutive women with surgically diagnosed invasive breast cancer between January 2007 and December 2012 was performed. After individual matching, women were allocated into either an EIC-positive or an EIC-negative group. Imaging factors associated with prognosis were investigated. The recurrence-free and overall survival rates were compared. Univariable and multivariable analyses were performed to analyze the effect of EIC. Results Among 6136 included women (mean age, 48.9 years ± 9.8), 1800 EIC-positive and 4336 EIC-negative breast cancers were identified. After matching according to EIC presence was performed, 1551 women were allocated into each group. The mean follow-up period was 79.9 months. The local-regional recurrence rate in the EIC-positive group was higher than that in the EIC-negative group (39.4% [63 of 160] vs 25.5% [37 of 145]; P = .001). However, there were no significant differences in total recurrence rate (hazard ratio [HR]: 1.2; 95% confidence interval [CI]: 0.9, 1.4; P = .21) or death (HR: 1.1; 95% CI: 0.8, 1.5; P = .45). EIC was not a significant independent factor for recurrence-free survival (HR: 1.1; 95% CI: 0.9, 1.4; P = .45) or death (HR: 1.1; 95% CI: 0.8, 1.6; P = .44) in multivariable analyses. Calcification and non-mass lesions were more commonly seen at US and MRI in the EIC-positive group than in the EIC-negative group (P < .001). Conclusion The presence of an extensive intraductal component in women with invasive breast cancer did not affect overall survival or recurrence-free survival. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Eby in this issue.