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Aim of study <p>To assess MRI features of invasive breast cancer in relation to lymphovascular invasion (LVI) and its clinicopathological associations.</p> Methods <p>This retrospective study included 103 cases of pathologically proven breast cancer who had undergone preoperative MRI including conventional study, dynamic contrast-enhanced study (DCE) and diffusion-weighted imaging (DWI). Lesions were reviewed and described according to Breast Imaging Reporting and Data System (BIRADS) lexicon 2013 edition in addition to other MRI findings including: peritumoral edema, intratumoral high T2 signal intensity, tumor apparent diffusion coefficient (ADC) value, peritumoral ADC value, and peritumor–tumor ADC ratio. Histopathological and immunohistochemical analysis was done. Presence or absence of lymphovascular invasion (LVI) on postoperative histopathology was assessed. Statistical analyses were performed to identify significant MRI findings found with LVI as well as its clinicopathological associations.</p> Results <p>Higher T-stage of the tumor (<i>p</i> &lt; 0.0001), tumor histologic grade (<i>p</i> &lt; 0.0001), molecular subtype (negative hormonal and positive HER2 status), high Ki-67 proliferation index (<i>p</i> &lt; 0.0001), peritumoral edema (<i>p</i> &lt; 0.001), intratumoral high T2 signal intensity (<i>p</i> &lt; 0.001) were significantly associated with LVI. The tumor ADC value (<i>p</i> = 0.034), peritumoral ADC value (<i>p</i> &lt; 0.001), and peritumor–tumor ADC ratio (<i>p</i> &lt; 0.001) had significant correlation with LVI. Prediction of LVI can be made using cutoff value for peritumoral ADC (&gt; 1.5) and peritumor/tumor ADC ratio (&gt; 1.9) (<i>p</i> &lt; 0.001).</p> Conclusions <p>We found that lymphovascular invasion was more common in HER2-positive molecular subtypes and high-grade invasive tumors. T2-weighted imaging was helpful in detecting peritumoral edema and intratumoral high T2 signal which is strongly associated with lymphovascular invasion. Peritumoral ADC value and peritumor–tumor ADC ratio can be predictive MRI findings for LVI. This can impact management plans and patient prognosis especially in node-negative invasive breast cancer cases.</p>

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Can MRI predict lymphovascular invasion in breast cancer? A radiological-pathological observational insights

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月8日

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  • Nehal Magdy Settein,
  • Fatma Mohamed Sherif,
  • Eman Ashraf Saad

摘要

Aim of study

To assess MRI features of invasive breast cancer in relation to lymphovascular invasion (LVI) and its clinicopathological associations.

Methods

This retrospective study included 103 cases of pathologically proven breast cancer who had undergone preoperative MRI including conventional study, dynamic contrast-enhanced study (DCE) and diffusion-weighted imaging (DWI). Lesions were reviewed and described according to Breast Imaging Reporting and Data System (BIRADS) lexicon 2013 edition in addition to other MRI findings including: peritumoral edema, intratumoral high T2 signal intensity, tumor apparent diffusion coefficient (ADC) value, peritumoral ADC value, and peritumor–tumor ADC ratio. Histopathological and immunohistochemical analysis was done. Presence or absence of lymphovascular invasion (LVI) on postoperative histopathology was assessed. Statistical analyses were performed to identify significant MRI findings found with LVI as well as its clinicopathological associations.

Results

Higher T-stage of the tumor (p < 0.0001), tumor histologic grade (p < 0.0001), molecular subtype (negative hormonal and positive HER2 status), high Ki-67 proliferation index (p < 0.0001), peritumoral edema (p < 0.001), intratumoral high T2 signal intensity (p < 0.001) were significantly associated with LVI. The tumor ADC value (p = 0.034), peritumoral ADC value (p < 0.001), and peritumor–tumor ADC ratio (p < 0.001) had significant correlation with LVI. Prediction of LVI can be made using cutoff value for peritumoral ADC (> 1.5) and peritumor/tumor ADC ratio (> 1.9) (p < 0.001).

Conclusions

We found that lymphovascular invasion was more common in HER2-positive molecular subtypes and high-grade invasive tumors. T2-weighted imaging was helpful in detecting peritumoral edema and intratumoral high T2 signal which is strongly associated with lymphovascular invasion. Peritumoral ADC value and peritumor–tumor ADC ratio can be predictive MRI findings for LVI. This can impact management plans and patient prognosis especially in node-negative invasive breast cancer cases.