Can breast MRI and adjunctive Doppler ultrasound improve the accuracy of predicting pathological complete response after neoadjuvant chemotherapy?

Background To examine the accuracy of MRI and Doppler ultrasound (US) for detecting residual tumor after neoadjuvant chemotherapy (NAC) for breast cancer and evaluate whether adjunctive Doppler US improves the MRI accuracy. Methods We reviewed 276 invasive breast cancer cases treated with NAC. Tumor...

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Bibliographic Details
Published in:Breast cancer (Tokyo, Japan) Japan), 2021-09, Vol.28 (5), p.1120-1130
Main Authors: Nakashima, Kazuaki, Uematsu, Takayoshi, Harada, Taiyo L., Takahashi, Kaoru, Nishimura, Seiichirou, Tadokoro, Yukiko, Hayashi, Tomomi, Watanabe, Junichiro, Sugino, Takashi, Notsu, Akifumi
Format: Article
Language:English
Subjects:
Adjuvant treatment
Adult
Aged
Aged, 80 and over
Breast Neoplasms - diagnostic imaging
Breast Neoplasms - pathology
Cancer
Cancer Research
Comparative analysis
Estrogen
Female
Gadobutrol
Humans
Magnetic resonance imaging
Magnetic Resonance Imaging - standards
Medicine
Medicine & Public Health
Middle Aged
Neoadjuvant Therapy - methods
Neoplasm, Residual - diagnostic imaging
Neoplasm, Residual - pathology
Oncology
Original Article
Retrospective Studies
Surgery
Surgical Oncology
Ultrasonography, Doppler - standards
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Summary:Background To examine the accuracy of MRI and Doppler ultrasound (US) for detecting residual tumor after neoadjuvant chemotherapy (NAC) for breast cancer and evaluate whether adjunctive Doppler US improves the MRI accuracy. Methods We reviewed 276 invasive breast cancer cases treated with NAC. Tumors were classified into four subtypes based on estrogen receptor and HER2 status. Response to NAC was evaluated using contrast-enhanced MRI and Doppler US. Residual Doppler flow was assumed to indicate a residual tumor. MRI and Doppler findings were compared with the histopathological findings of resected specimens. Pathological complete response (pCR) was defined as neither in situ nor invasive cancer left. Results Of the 276 tumors, imaging complete responses were observed using MRI and Doppler US in 62 (22%) and 111 (40%), respectively, whereas pCR was achieved in 44 (16%). MRI and Doppler US predicted residual tumor with 88% and 69% sensitivity, 80% and 91% specificity, 87% and 73% accuracy, 96% and 98% PPV, and 56% and 36% NPV, respectively. The accuracies of MRI and Doppler US were significantly higher for HER2-negative than HER2-positive tumors ( p  
ISSN:1340-6868
1880-4233
DOI:10.1007/s12282-021-01249-6