Association of MRI biomarkers on survival in TNBC patients: A retrospective, multi-center cohort study.
Bibliographic record
Abstract
e13155 Background: Triple-negative breast cancer (TNBC) is an aggressive subtype associated with heterogenous radiological and histopathological findings. Emerging MRI-based biomarkers—such as peritumoral edema and rim enhancement—may better predict disease progression and recurrence. However, multi-center evidence remains limited, warranting further investigation. Methods: In this retrospective study, women diagnosed with triple-negative breast cancer (TNBC) in the Canadian province of Saskatchewan from 2017 to 2021 were identified. Radiologist MRI reports were independently evaluated and coded to document the presence of peritumoral edema and rim enhancement. Multifactorial data on patient demographics, treatment, and staging were also collected. The relationship between these MRI features and overall survival was analyzed by a non-parametric survival analysis and Cox regression analyses. Chi-squared tests were conducted to evaluate differences in key clinical and pathological outcomes among patients with or without peritumoral edema and rim enhancement. Results: 380 patients with TNBC were included in the study, of which 174 received a breast MRI within 6 months of their diagnosis. Of these patients, 38 (10.0%) had peritumoral edema pre-systemic therapy, and 44 (11.5%) had rim enhancement pre-systemic therapy. The median overall survival for those with peritumoral edema was 1.88 years (95% CI, 1.29 - 6.15) and 2.47 years (95% CI, 1.35 – 6.15) for those with rim enhancement, as compared to 5.10 years (95% CI, 4.30-6.79) for the entire study population. Multivariate analysis demonstrated that peritumoral edema (p = 0.36, HR [95% CI] = 1.53 [0.61 –3.81] and rim enhancement (p = 0.21, HR [95% CI] = 1.81 [0.71 – 4.63] were not significant predictors of overall survival. Those with peritumoral edema were more likely to undergo first-line dose reduction in systemic therapy (p = 0.01, OR [95% CI] = 2.96 [1.25 –7.04]), though this finding was not significant for those with rim enhancement (p = 0.12, OR [95% CI] = 2.08 [0.83 –5.23]). Amongst patients with post-resection pathology post-neoadjuvant systemic therapy, those with rim enhancement and/or peritumoral edema exhibited a greater rate of residual disease versus complete pathological response, though this result was statistically non-significant (p = 0.12, OR [95% CI] = 2.13 [0.83 –5.43]). Similar results were observed with tumor necrosis on post-resection pathology post-neoadjuvant chemotherapy (p = 0.23, OR [95% CI] = 2.03 [0.65 –6.38]). Conclusions: The presence of peritumoral edema and rim enhancement were associated with poor survival outcomes in TNBC. However, these findings are not definitively extended to treatment response, treatment course and pathological outcomes. Larger datasets are required to better elucidate a possible connection between MRI-biomarkers and post-treatment pathology and prognosis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".