Objective  To establish a prediction model for the distant metastasis of breast cancer based on qualitative magnetic resonance imaging (MRI) parameters.

  Methods  A retrospective analysis of 3, 032 patients with breast MRI from January 2011 to December 2016 in Tianjin Medical University Cancer Institute and Hospital was conducted. After the confirmation of invasive breast cancer, the subjects were divided in 2 groups: metastasis and metastasis-free. A total of 93 patients were included in the metastasis group, and 186 patients without the presence of distant metastasis in the metastasis-free group. We analyzed the correlation between breast cancer molecular subtypes and distant metastasis in the metastasis group. Univariate and Logistic regression analyses of qualitative MRI features were performed for the groups. Subsequently, we used the results to establish prediction models.

  Results  The results showed that hormone receptor-positive tumors (Luminal type) had a greater tendency to develop bone metastasis in the metastasis group. Triple-negative tumors showed a greater tendency to develop lung metastasis. Human epidermal growth factor receptor 2 gene overexpression cases were more likely to develop liver metastasis. The results of the univariate analysis showed that the type of lesion, multifocality or multicentricity of the cancer, T1-weighted signal uniformity, T2-weighted signal uniformity, and tumor size were statistically different between the groups (P < 0.05). The results of the logistic regression analysis showed that the type of lesion, multifocality or multicentricity of the cancer, T2-weighted signal uniformity, and tumor size were independent predictors of distant metastasis. Based on select independent predictors, we established a prediction model for the distant visceral metastasis of breast cancer. The accuracy, area under the curve, sensitivity, and specificity of the model were 82.8%, 0.801, 85.7%, and 75.0%, respectively.

  Conclusions  The prediction model based on the clinical pathology and MRI features established in this study can predict the distant metastasis of breast cancer.