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Muhammad Imran Farid
Muhammad Taha Khalil
Dr. Nada Ullah
Amanullah Khan
Muhammad Imran Siddiqui
Kamran Illahi Memon
Syed Abdullah Haider
Naheed Akhtar


breast cancer recurrence, DCE MRI, BPE, risk stratification, personalized treatment


Introduction: Potential as a prognostic tool for breast cancer recurrence risk is the evaluation of background parenchymal enhancement (BPE) using dynamic contrast-enhanced (DCE) MRI. BPE has been identified as a possible marker of therapy responsiveness and disease aggressiveness, reflecting the vascular and hormonal milieu of breast tissue. This research uses information from DCE-MRI scans to assess how well BPE values predict the probability of breast cancer recurrence.

Methodology: The retrospective cohort study was conducted and included fifty eligible participants, diagnosed with breast cancer and undergoing MRI between January and December 2023. Data on demographics, clinical features, and MRI results were collected from medical records of a Tertiary Care hospital in Pakistan. BPE was quantitatively assessed using an in-house algorithm, and statistical analysis included descriptive statistics, logistic regression, and Cox proportional hazards regression. MRI protocols followed standard procedures. The study aimed to assess the prognostic value of BPE in guiding personalized breast cancer treatment and risk stratification.

Results: The research highlights the wide age representation with an average participant age of 48.5 years (±7.2 years). The fact that premenopausal state accounted for 65% of participants is noteworthy and highlights the importance of hormonal status in breast cancer research and treatment approaches. There was a significant degree of heterogeneity in the tumor's size and grade, with an average tumor size of 3.8 cm (±1.2 cm) and a heterogeneous distribution across grades. Treatment choices were guided by the results of a hormone receptor status study, which showed prevalence rates of estrogen receptor (ER) positive at 37%, progesterone receptor (PR) positive at 52%, and HER2 positive at 11%. The majority of treatment options for breast cancer were surgery, chemotherapy, and radiation therapy, which demonstrated the interdisciplinary nature of breast cancer care. The results of the follow-up showed a 20% recurrence rate, underscoring the significance of risk stratification according to Oncotype DX scores. greater BPE readings were linked to a greater likelihood of high-risk recurrence scores. The results of MRI, in particular, showed a substantial correlation with recurrence risk. The predictive efficacy of BPE evaluation was further highlighted by Cox proportional hazards regression analysis, indicating its potential prognostic relevance in clinical practice.

Conclusion: Our research shows a strong relationship between breast cancer recurrence risk and BPE in DCE-MRI. We discovered significant differences in tumor features, hormone receptor status, and treatment modalities after analyzing a heterogeneous sample, underscoring the difficulty in managing breast cancer. Elevated BPE levels were linked to heightened chances of high-risk recurrence scores, indicating the predictive significance of BPE evaluation for customized therapy and risk classification. Recurrence prediction and patient outcomes may be improved by incorporating BPE examination into clinical practice.

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