Analysis of Factors that Influence the Accuracy of Magnetic Resonance Imaging for Predicting Response after Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

• Published in: Annals of surgical oncology 2013-08, Vol.20 (8), p.2562-2568
• Main Authors: Ko, Eun Sook, Han, Boo-Kyung, Kim, Rock Bum, Ko, Eun Young, Shin, Jung Hee, Hahn, Soo Yeon, Nam, Seok Jin, Lee, Jeong Eon, Lee, Se Kyung, Im, Young-Hyuck, Park, Yeon Hee
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibodies, Monoclonal, Humanized - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Breast Neoplasms - drug therapy; Breast Neoplasms - metabolism; Breast Neoplasms - pathology; Breast Oncology; Carcinoma, Ductal, Breast - drug therapy; Carcinoma, Ductal, Breast - metabolism; Carcinoma, Ductal, Breast - pathology; Chemotherapy, Adjuvant; Cyclophosphamide - administration & dosage; Doxorubicin - administration & dosage; False Negative Reactions; False Positive Reactions; Female; Humans; Magnetic Resonance Imaging; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy; Oncology; Predictive Value of Tests; Receptor, ErbB-2 - metabolism; Receptors, Estrogen - metabolism; Receptors, Progesterone - metabolism; Retrospective Studies; Statistics, Nonparametric; Surgery; Surgical Oncology; Taxoids - administration & dosage; Trastuzumab; Treatment Outcome; Tumor Burden - drug effects; Young Adult
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1245/s10434-013-2925-6

Purpose The purpose of this study was to evaluate the accuracy of breast magnetic resonance imaging (MRI) to predict residual lesion size after neoadjuvant chemotherapy (NAC) and to determine the factors that influence the accuracy of response prediction. Methods This study comprised 166 patients who underwent MRI before and after NAC, but before surgery. The longest diameter of the residual cancer was measured using MRI and correlated with pathologic findings. Patients were further divided into subgroups according to various radiologic and histopathologic factors. Pathologic complete response (pCR) was defined as the absence of residual invasive cancer cells. The Pearson correlation was used to correlate tumor size as determined by MRI and pathology, and the Mann-Whitney U test and Kruskal-Wallis test were used to compare MRI-pathologic size discrepancies according to various clinical, histopathologic factors, and MRI findings. Results Of the 166 women, 40 achieved pCR. The overall sensitivity, specificity, and accuracy for diagnosing invasive residual disease by using MRI were 96, 65, and 89 %, respectively. The Pearson’s correlation coefficient between the tumor sizes measured using MRI and pathology was 0.749 ( P