Fig. 3
One example of the point-based scoring system for predicting breast cancer patients without axillary lymph node metastasis. A ~ F are MRI images of a female right breast cancer patient with invasive ductal carcinoma who was positive for human epidermal growth factor receptor-2, negative for estrogen receptor, AJCC stage III, and T2 stage. An axial contrast-enhanced T1WI image (A) shows a tumor with a maximum diameter of 2.3 cm located in the lower-outer quadrant. The mean values of Kep, Ve, and TTP from the corresponding pseudocolor images of Kep (B), Ve, (C), and TTP (D) were 0.760 min−1, 0.190, and 0.620 min, respectively. Breast MRI was suspicious for axillary lymph node metastasis based on the following features: axial T2WI with fat suppression imaging (E) and axial contrast-enhanced T1WI imaging (F) showing cortical thickening, an oval shape and a long-to-short axis ratio of 1.4 for a maximal lymph node (white arrow) in axillary level I (nodes lateral and inferior to pectoralis minor muscle). However, the risk of axillary lymph node metastasis assessed by the scoring system was 17.0, with an axillary lymph node metastasis probability of 26.9%. The final postoperative pathology report showed that this tumor had no axillary lymph node metastasis