A study on the prognostic assessment of triple-negative breast cancer using habitat analysis of preoperative DCE-MRI subtraction maps

Assessment of disease-free survival (DFS) in triple-negative breast cancer (TNBC) using habitat analysis of preoperative DCE-MRI subtraction maps.

Study Design: Retrospective collection of consecutive patients with pathologically confirmed TNBC from January 2019 to January 2025.
Data Collection: DCE subtraction maps were used to obtain wash-in and washout ratio maps for habitat analysis.
Statistical Analysis: Kaplan-Meier survival analysis and multivariable Cox regression analyses were performed to identify independent risk factors for TNBC recurrence.

145 patients were enrolled, with 29 experiencing recurrence.
Habitat intratumoral heterogeneity (ITH) was significantly higher in the high-risk recurrence group (0.59 ± 0.14) compared to the low-risk group (0.42 ± 0.22, P < 0.001).
The AUC for habitat ITH in diagnosing TNBC recurrence was 0.71 (95% CI: 0.616-0.805, P < 0.05).
Habitat ITH was identified as an independent predictor of poorer DFS (HR 1.465, 95% CI: 1.086-2.073, P = 0.013).

Habitat analysis of preoperative DCE-MRI subtraction maps contributes to the prognostic assessment of TNBC.

The study is retrospective and may have inherent biases that could affect the generalizability of the findings.
The biological interpretation of subregions segmented via unsupervised clustering may be ambiguous, complicating the understanding of tumor heterogeneity.

Habitat analysis using DCE-MRI subtraction maps provides a novel imaging basis for assessing tumor heterogeneity and prognostic evaluation in TNBC.