[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-336146-105":59,"doc-detail-336146-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","prognostic-molecular-biomarkers-in-breast-cancer-lesions-with-non-mass-enhancement-on-mr","Prognostic Molecular Biomarkers in Breast Cancer Lesions with Non-Mass Enhancement on MR","","Clustered ring enhancement (CRE) is introduced as a new term for non-mass enhancement (NME) on breast MRI in BIRADS 5, reflecting high malignancy suspicion. This retrospective study collected 58 breast lesions reported with NME between July 2013 and December 2018 and compared MRI enhancement patterns with pathology and immunohistochemical biomarker expression. CRE-associated lesions showed significantly lower ER and PR, higher Ki-67 (≥25%), and a reduced ER expression ratio, suggesting a more aggressive molecular profile.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/prognostic-molecular-biomarkers-in-breast-cancer-lesions-with-non-mass-enhancement-on-mr/336146/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/prognostic-molecular-biomarkers-in-breast-cancer-lesions-with-non-mass-enhancement-on-mr/336146.png","ImageObject",300,407,{"name":92,"@type":93},"Ava Thompson","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-24","2026-09-21",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is clustered ring enhancement (CRE) in breast MRI?","Question",{"text":112,"@type":113},"CRE is a term for non-mass enhancement (NME) in BIRADS 5, defined as thin rings of enhancement clustered together around the ducts.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How were the breast lesions selected for this study?",{"text":117,"@type":113},"The study retrospectively collected 58 breast lesions that MRI reported with NME between July 2013 and December 2018.",{"name":119,"@type":110,"acceptedAnswer":120},"Which molecular biomarkers differed between CRE and non-CRE lesions?",{"text":121,"@type":113},"CRE lesions had significantly lower estrogen receptor (ER) and progesterone receptor (PR) expression, higher Ki-67 (≥25%), and a lower ER expression ratio compared with lesions without CRE.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},336146,1790120391,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1649267921044,"https://us-avatar.wpscdn.com/avatar/1800007509477c92dfb?_k=1786009248482753345","diagnostics  \nArticle  \nPrognostic Molecular Biomarkers in Breast Cancer Lesions with Non-Mass Enhancement on MR  \nMei-Lin Wang 1, Yu-Pin Chang 2,1, *, Chen-Hao Wu 1, Chuan-Han Chen 1, Mein-Kai Gueng 1, Yi-Ying Wu 1 and Jyh-Wen Chai 1  \n1 Department of Radiology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; [wmlovej@gmail.com](wmlovej@gmail.com) (M.-L.W.)  \n2 Premium Health Examination Center, Tungs’Taichung MetroHarbor Hospital, Taichung 43503, Taiwan  \n* [Correspondence: b101091052@hotmail.com](Correspondence: b101091052@hotmail.com)  \nCitation: Wang, M.-L.; Chang, Y.-P.; Wu, C.-H.; Chen, C.-H.; Gueng, M.-K.; Wu, Y.-Y.; Chai, J.-W. Prognostic Molecular Biomarkers in Breast Cancer Lesions with Non-Mass Enhancement on MR. Diagnostics 2024, 14, 747. [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)diagnostics14070747  \nAcademic Editor: Sung Chul Lim  \nReceived: 29 February 2024  \nRevised: 26 March 2024  \nAccepted: 27 March 2024  \nPublished: 30 March 2024  \nCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) .  \nAbstract: Clustered ring enhancement (CRE) is a new lexicon for non-mass enhancement (NME) of breast MR in the 5th BIRADS, indicating a high suspicion of malignancy. We wonder if the presence of CRE correlates with expression of prognostic molecular biomarkers of breast cancer. A total of 58 breast lesions, which MRI reported with NME, were collected between July 2013 and December 2018. The patterns of enhancement including CRE were reviewed and the pathological results with expression of molecular biomarkers were collected. The association between MRI NME, pathological, and IHC stain findings were investigated under univariate analysis. A total of 58 breast lesions were pathologically proven to have breast cancer, comprising 31 lesions with CRE and 27 lesions without CRE on breast MRI. The expression of the estrogen receptor (ER) (p = 0.017) and the progesterone receptor (PR) (p = 0.017) was significantly lower in lesions with CRE as compared with those without CRE. The expression of Ki-67 (≥25%) was significantly higher in lesions with CRE (p = 0.046) . The lesions with CRE had a lower expression ratio of ER (50.71 ± 45.39% vs. 74.26 ± 33.59%, p = 0.028) . Our study indicated that lesions with CRE may possess different features from those without CRE in molecular expression, bearing a more aggressive behavior.  \nKeywords: magnetic resonance imaging; breast neoplasms; prognosis; retrospective studies  \n1. Introduction  \nClustered ring enhancement (CRE) is a newly added lexicon for non-mass enhancement (NME) in the 5th BIRADS.  \nBreast cancer is the most frequently diagnosed invasive cancer in the world, and is also the leading cause of cancer death in women in developed and high-income countries [1]. Breast cancer is also the most common female cancer, with an age-standardized incidence rate of 81.0 per 100,000 persons in 2019 in Taiwan [2]. The mortality rate of breast cancer ranked the fourth highest among all cancer types in 2021 in Taiwan. Peak incidence is at 50–59 years old. Although age-standardized incidence rates per 100,000 persons progressively gets higher (as compared with 49.99 in 2006), the age-standardized mortality rate per 100,000 persons did not significantly increase (13.8 in 2021 vs. 10.41 in 2006) [2,3]. Good prognosis may result from the improvement of screening policy, diagnostic tools, and treatment planning. Female mammographic screening as a public health policy started in 2002, and some women have decided to perform self-paid breast MRI.  \nMedical advances have transformed the previously surgical-only disease into a multidisciplinary approach for b","cbCaitkDtnjLE77T","https://ap.wps.com/l/cbCaitkDtnjLE77T","pdf",2285773,11,"English","# Introduction\n## Clustered ring enhancement as a BIRADS 5 lexicon\n## Rationale for molecular biomarker evaluation\n# Methods\n## Study design and lesion selection\n## MRI enhancement pattern review\n## Pathology and IHC biomarker assessment\n# Results\n## CRE vs non-CRE biomarker expression\n# Discussion\n## Clinical implications of CRE-associated molecular profiles","[{\"question\":\"What is clustered ring enhancement (CRE) in breast MRI?\",\"answer\":\"CRE is a term for non-mass enhancement (NME) in BIRADS 5, defined as thin rings of enhancement clustered together around the ducts.\"},{\"question\":\"How were the breast lesions selected for this study?\",\"answer\":\"The study retrospectively collected 58 breast lesions that MRI reported with NME between July 2013 and December 2018.\"},{\"question\":\"Which molecular biomarkers differed between CRE and non-CRE lesions?\",\"answer\":\"CRE lesions had significantly lower estrogen receptor (ER) and progesterone receptor (PR) expression, higher Ki-67 (≥25%), and a lower ER expression ratio compared with lesions without CRE.\"}]","Prognostic Molecular Biomarkers in Breast Cancer Lesions with Non-Mass Enhancement on MR | PDF",1790013808,28]