Breast Cancer, MRSI, MRI, Cancer Biomarkers
Background: Breast cancer is the fifth most common cause of cancer death worldwide and most serious form of neoplastic diseases in both developed and developing countries. Mammography and ultrasound are the most often used screening methods in breast cancer. Magnetic Resonance Imaging (MRI) uses the protons in water and fat to create the image of breast cancer. But recent studies says neoplastic breast lesions contains elevated choline concentration (tCho) and altered mean apparent diffusion coefficient (ADC) which can be used as good biomarkers to evaluate the cancer stages even follow up the Neoadjuvent Chemotherapy (NACT).
Aim & Objectives:
1. To evaluate the relation of age, tCho concentration and mean ADC with breast cancer.
2. To estimate the correlation between the factors.
3. To calculate the main difference between breast cancer patient before and after menopause.
Methods/Study Design: This was a cross sectional, observational study done on 14 randomly selected diagnosed stage I breast cancer patients newly registered in surgery department of All India Institute of Medical Sciences, New Delhi, India during 3 months study period. Intentionally 7 of them were selected to be postmenopausal and rest 7 premenopausal. Patients with claustrophobia, serious illness, pacemaker or associated diseases were excluded. Volunteers were selected by lottery method after confirmation of absence of the exclusion criteria in them. All the breast MRS images were taken only after signing the consent form of being a volunteer for the study with breast coil. All the spectroscopic images were analyzed with computer technologies and SPPS software with the help of non-parametric statistical tests.
Results/Findings: Mean age of patients were 44.85±6.97 where in premenopausal and postmenopausal women it was 40.14±4.59 and 49.57±5.26 respectively. tCho concentration was high in postmenopausal women (4.85±2.64 mmol/kg vs 3.72±1.64) where unlike to them premenopausal women showed higher mean ADC values (1.02±0.20 vs 0.91±0.09). All together weak correlation (r= 0.439) found in between the tCho and mean ADC where age and tCho were weakly correlated among the premenopausal patients (r=0.440). Among the postmenopausal women strong correlation found in between age tCho and mean ADC (r=0.620) and age and mean ADC (r=0.498).
Study Limitations: It was short term study with very less population of same category of breast cancer which can be more appreciated if done in a large population cohort study design though as a pilot study the aims were satisfactorily reached.
Conclusion: Postmenopausal women show adverse conditions in breast cancer and using tCho and mean ADC as biomarkers; the management process becomes easier for a doctor.
