TY - JOUR
T1 - BI-RADS Ultrasound Lexicon Descriptors and Stromal Tumor-Infiltrating Lymphocytes in Triple-Negative Breast Cancer
AU - Candelaria, Rosalind P.
AU - Spak, David A.
AU - Rauch, Gaiane M.
AU - Huo, Lei
AU - Bassett, Roland L.
AU - Santiago, Lumarie
AU - Scoggins, Marion E.
AU - Guirguis, Mary S.
AU - Patel, Miral M.
AU - Whitman, Gary J.
AU - Moulder, Stacy L.
AU - Thompson, Alastair M.
AU - Ravenberg, Elizabeth E.
AU - White, Jason B.
AU - Abuhadra, Nour K.
AU - Valero, Vicente
AU - Litton, Jennifer
AU - Adrada, Beatriz E.
AU - Yang, Wei T.
N1 - Funding Information:
This study was supported in part by the NIH/NCI under award number P30 CA016672 , the MD Anderson Cancer Center Breast Cancer Moonshot Program , and a CPRIT Multi-Investigator Research Award (MIRA) : RP160710-C1-CPRIT .
Publisher Copyright:
© 2021 The Association of University Radiologists
PY - 2022/1
Y1 - 2022/1
N2 - Purpose: Increased levels of stromal tumor-infiltrating lymphocytes (sTILs) have recently been considered a favorable independent prognostic and predictive biomarker in triple-negative breast cancer (TNBC). The purpose of this study was to determine the relationship between BI-RADS (Breast Imaging Reporting and Data System) ultrasound lexicon descriptors and sTILs in TNBC. Materials and Methods: Patients with stage I-III TNBC were evaluated within a single-institution neoadjuvant clinical trial. Two fellowship-trained breast radiologists used the BI-RADS ultrasound lexicon to assess pretreatment tumor shape, margin, echo pattern, orientation, posterior features, and vascularity. sTILs were defined as low <20 or high ≥20 on the pretreatment biopsy. Fisher's exact tests were used to assess the association between lexicon descriptors and sTIL levels. Results: The 284 patients (mean age 52 years, range 24-79 years) were comprised of 68% (193/284) with low-sTIL tumors and 32% (91/284) with high-sTIL tumors. TNBC tumors with high sTILs were more likely to have the following features: (1) oval/round shape than irregular shape (p = 0.003), (2) circumscribed or microlobulated margins than spiculated, indistinct, or angular margins (p = 0.0005); (3) complex cystic and solid pattern than heterogeneous pattern (p = 0.006); and (4) posterior enhancement than shadowing (p = 0.002). There was no significant association between sTILs and descriptors for orientation and vascularity (p = 0.06 and p = 0.49, respectively). Conclusion: BI-RADS ultrasound descriptors of the pretreatment appearance of a TNBC tumor can be useful in discriminating between tumors with low and high sTIL levels. Therefore, there is a potential use of ultrasound tumor characteristics to complement sTILs when used as stratification factors in treatment algorithms for TNBC.
AB - Purpose: Increased levels of stromal tumor-infiltrating lymphocytes (sTILs) have recently been considered a favorable independent prognostic and predictive biomarker in triple-negative breast cancer (TNBC). The purpose of this study was to determine the relationship between BI-RADS (Breast Imaging Reporting and Data System) ultrasound lexicon descriptors and sTILs in TNBC. Materials and Methods: Patients with stage I-III TNBC were evaluated within a single-institution neoadjuvant clinical trial. Two fellowship-trained breast radiologists used the BI-RADS ultrasound lexicon to assess pretreatment tumor shape, margin, echo pattern, orientation, posterior features, and vascularity. sTILs were defined as low <20 or high ≥20 on the pretreatment biopsy. Fisher's exact tests were used to assess the association between lexicon descriptors and sTIL levels. Results: The 284 patients (mean age 52 years, range 24-79 years) were comprised of 68% (193/284) with low-sTIL tumors and 32% (91/284) with high-sTIL tumors. TNBC tumors with high sTILs were more likely to have the following features: (1) oval/round shape than irregular shape (p = 0.003), (2) circumscribed or microlobulated margins than spiculated, indistinct, or angular margins (p = 0.0005); (3) complex cystic and solid pattern than heterogeneous pattern (p = 0.006); and (4) posterior enhancement than shadowing (p = 0.002). There was no significant association between sTILs and descriptors for orientation and vascularity (p = 0.06 and p = 0.49, respectively). Conclusion: BI-RADS ultrasound descriptors of the pretreatment appearance of a TNBC tumor can be useful in discriminating between tumors with low and high sTIL levels. Therefore, there is a potential use of ultrasound tumor characteristics to complement sTILs when used as stratification factors in treatment algorithms for TNBC.
KW - BI-RADS, Breast Imaging Reporting and Data System
KW - BI-RADS. Abbreviations: ACR, American College of Radiology
KW - breast ultrasound
KW - ER, estrogen receptor
KW - HER2, human epidermal growth factor receptor 2
KW - pCR, pathologic complete response
KW - PR, progesterone receptor
KW - sTIL, stromal tumor-infiltrating lymphocyte
KW - stromal tumor infiltrating lymphocytes (sTILs)
KW - TNBC, triple-negative breast cancer
KW - Triple-negative breast cancer
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U2 - 10.1016/j.acra.2021.06.007
DO - 10.1016/j.acra.2021.06.007
M3 - Article
C2 - 34272161
AN - SCOPUS:85110544231
SN - 1076-6332
VL - 29
SP - S35-S41
JO - Academic radiology
JF - Academic radiology
ER -