Published online Apr 28, 2026. doi: 10.4329/wjr.v18.i4.119347
Revised: February 20, 2026
Accepted: April 2, 2026
Published online: April 28, 2026
Processing time: 89 Days and 13 Hours
Breast magnetic resonance imaging (MRI) provides valuable information for tumor detection, as well as potential applications in molecular characterization and prognostication. A key feature detectable on MRI is the presence of breast edema, which has been associated with tumor aggressiveness and poorer clinical outcomes.
To determine the correlation between intramammary edema patterns as observed on breast MRI and the histopathological and molecular characteristics of the tumor.
In this retrospective single-center study, 123 women with biopsy-proven breast cancer underwent preoperative breast MRI from June 2022 to June 2025. The classification of edema was determined on T2-weighted images, divided into four breast edema score (BES) categories: BES-1 (no edema), BES-2 (peritumoral edema), BES-3 (prepectoral edema), and BES-4 (subcutaneous edema). The MRI findings were correlated with histological type, molecular subtype, receptor status, Ki67 index, and lymph node involvement. Data analysis was conducted using IBM SPSS Statistics for Windows, version 28.
Edema was observed in 45.5% of patients. Statistically significant correlation was observed between BES and molecular subtypes (P < 0.001), hormone receptor status (P < 0.001), and human epidermal growth factor receptor 2 expression (P < 0.001). Higher BES categories (BES 2-4) exhibited a higher prevalence in human epidermal growth factor receptor 2-positive and triple-negative tumors, while the absence of edema (BES-1) demonstrated a predominance in hormone receptor-positive subtypes.
The presence and severity of MRI-based breast edema score have been found to correlate with aggressive molecular subtypes, underscoring the potential role of BES in prognostic stratification and guiding tailored treat
Core Tip: Magnetic resonance imaging-based assessment of intramammary edema may serve as a practical imaging biomarker reflecting breast cancer biology. Using a simple four-level breast edema score on T2-weighted images, edema patterns can be linked to key histopathological and molecular features, including tumor subtype, receptor status, proliferation index, and nodal involvement. Higher breast edema score categories tend to accompany more aggressive molecular profiles, whereas the absence of edema is more frequently observed in hormone receptor-positive disease. Therefore, incorporating breast edema scoring into routine preoperative magnetic resonance imaging interpretation could support risk stratification and help guide individualized treatment planning in clinical practice.