Effect of aromatase inhibitors on background parenchymal enhancement and amount of fibroglandular tissue at breast MR imaging Journal Article


Authors: King, V.; Goldfarb, S. B.; Brooks, J. D.; Sung, J. S.; Nulsen, B. F.; Jozefara, J. E.; Pike, M. C.; Dickler, M. N.; Morris, E. A.
Article Title: Effect of aromatase inhibitors on background parenchymal enhancement and amount of fibroglandular tissue at breast MR imaging
Abstract: Purpose: To evaluate whether treatment with an aromatase inhibitor (AI) influences background parenchymal enhancement (BPE) or amount of fibroglandular tissue (FGT) at breast magnetic resonance (MR) imaging in postmenopausal women with prior history of breast cancer. Materials and Methods: A waiver of authorization and patient consent was granted by the institutional review board for this HIPAA-compliant retrospective study. Postmenopausal women with breast cancer and MR imaging findings of the contralateral unaffected breast, before and during 6-12 months of AI treatment (anastrozole, letrozole, or exemestane), between August 1999 and June 2010 were retrospectively identified (n = 149). Two readers performed blinded side-by-side comparison of BPE and MR imaging-depicted FGT before and during treatment. BPE and FGT were classified as the same or greater on one of the two MR studies and by using categorical scales: minimal, mild, moderate, or marked for BPE and fatty, scattered, heterogeneously dense, or dense for FGT. Consensus was reached in cases of disagreement. The sign test was used to conduct a side-by-side comparison of BPE and FGT before and during AI treatment. Results: A decrease in BPE occurred in 33.9% (37 of 109) of women during anastrozole treatment, while an increase occurred in only one (P < .0001); 28 of 37 decreases resulted in a category change of BPE. A decrease in MR imaging-depicted FGT occurred in 5.5% (six of 109) of women, while no increases occurred (P = .031). During letrozole treatment, a decrease in BPE occurred in 46% (15 of 33), while an increase occurred in one woman (P = .0003); a decrease in FGT occurred in only one woman, and no increases occurred. Similar results were seen when women also undergoing chemotherapy were excluded. Only seven women were treated with exemestane. Conclusion: Treatment with 6-12 months of anastrozole or letrozole was associated with decreases in BPE, which occurred in a greater proportion of women than decreases in FGT. © RSNA, 2012.
Keywords: adult; cancer chemotherapy; aged; aged, 80 and over; middle aged; retrospective studies; major clinical study; doxorubicin; fluorouracil; paclitaxel; cancer adjuvant therapy; methotrexate; nuclear magnetic resonance imaging; magnetic resonance imaging; neoplasm staging; breast cancer; image interpretation, computer-assisted; aromatase inhibitor; cyclophosphamide; breast neoplasms; retrospective study; age; cancer survivor; exemestane; cancer hormone therapy; image enhancement; subtraction technique; contrast enhancement; contrast media; letrozole; gadolinium pentetate; gadolinium dtpa; anastrozole; postmenopause; aromatase inhibitors; triazoles; nitriles; background parenchymal enhancement; radiological parameters; oncological parameters; androstadienes; fibroglandular tissue
Journal Title: Radiology
Volume: 264
Issue: 3
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2012-09-01
Start Page: 670
End Page: 678
Language: English
DOI: 10.1148/radiol.12112669
PROVIDER: scopus
PUBMED: 22771878
DOI/URL:
Notes: --- - "Export Date: 1 October 2012" - "CODEN: RADLA" - "Source: Scopus"
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MSK Authors
  1. Janice Sinae Sung
    67 Sung
  2. Malcolm Pike
    190 Pike
  3. Maura N Dickler
    262 Dickler
  4. Elizabeth A Morris
    336 Morris
  5. Valencia King
    7 King
  6. Shari Goldfarb
    149 Goldfarb
  7. Jennifer Brooks
    17 Brooks