Back to Search
Start Over
Accuracy of multi-parametric breast MR imaging for predicting pathological complete response of operable breast cancer prior to neoadjuvant systemic therapy.
- Source :
-
Magnetic resonance imaging [Magn Reson Imaging] 2019 Oct; Vol. 62, pp. 242-248. Date of Electronic Publication: 2019 Jul 25. - Publication Year :
- 2019
-
Abstract
- Objectives: To evaluate whether multiparametric breast-MRI, obtained before the initiation of neoadjuvant systemic therapy (NST) for operable breast cancer, predicts which cancer will achieve a pathological complete response (pCR) after the completion of NST.<br />Methods: This was an IRB-approved retrospective study on 31 consecutive patients (median age, 56 years) with operable invasive breast cancer (median size: 22 mm; triple-negative: 11/31 [35%], HER2-positive: 7/31 [23%], triple-positive: 13/31 [42%]) who underwent multiparametric DCE-MRI before the initiation of NST. The MRI protocol consisted of high-resolution dynamic contrast-enhanced MRI (DCE-MRI), T2-TSE, and DWI (b-values 0, 100, 800 s/mm <superscript>2</superscript> ). The results of surgical pathology after the completion of NST served as a standard of reference. Patient characteristics (age and menopausal status), pathological tumor characteristics (type, stage, nuclear grade, ER/PR and HER2 receptor status, and Ki-67 staining), and MRI characteristics (size, morphology, T2 signal intensity, enhancement kinetics, and ADC values) before NST were evaluated and compared between patients achieving pCR vs. non-pCR.<br />Results: Among 31 patients, 17 achieved pCR (55%) and 14 non-pCR (45%). No correlation was observed between patient- or tumor pathology-derived characteristics and pCR vs. non-pCR. Among MRI-derived tumor characteristics, tumor growth orientation parallel to Cooper's ligaments (p = 0.002) and wash-out rates (p = 0.019) correlated with pCR. Pre-NST ADC values were lower in patients achieving pCR (P = 0.086).<br />Conclusions: A tumor growth pattern parallel with Cooper's ligaments and a fast wash-out rate on pre-treatment multiparametric MRI are predictive of pCR and more closely associated with pCR than ADC values.<br /> (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Aged
Breast pathology
Breast Neoplasms pathology
Female
Humans
Kinetics
Middle Aged
Neoplasm Invasiveness
Receptor, ErbB-2 metabolism
Retrospective Studies
Treatment Outcome
Triple Negative Breast Neoplasms diagnostic imaging
Triple Negative Breast Neoplasms pathology
Triple Negative Breast Neoplasms surgery
Breast diagnostic imaging
Breast Neoplasms diagnostic imaging
Breast Neoplasms surgery
Magnetic Resonance Imaging
Neoadjuvant Therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1873-5894
- Volume :
- 62
- Database :
- MEDLINE
- Journal :
- Magnetic resonance imaging
- Publication Type :
- Academic Journal
- Accession number :
- 31352016
- Full Text :
- https://doi.org/10.1016/j.mri.2019.07.008