Neoadjuvant chemotherapy (NAC) has a major role in the treatment of breast cancer 1,2 .
the rate of response to NAC is limited and dependent on the subtypes of cancer 3,4 .
the identification of non-responding patients is important,
especially as it may allow considering alternative therapeutic options.
Pre-NAC semi-quantitative DCE-MRI parameters have been reported to be significantly different in chemosensitive and chemoresistant breast lesions 5-7 .
First studies on...
Methods and materials
This retrospective study was approved by our institutional ethical committee and included 70 patients.
All patients had an invasive breast carcinoma diagnosed on core-biopsy specimen.
To obtain a homogeneous histological sample for texture analysis,
only invasive ductal carcinomas with and without ductal carcinoma in situ were included in the study.
A baseline MRI as well as a pre-operative MRI to evaluate response to NAC was performed in all patients.
A pathological complete response (CR)...
Biological and imaging parameters Neither the mass enhancement nor the non-mass enhancement were statistically different between NR and PR+CR.
NR were significantly more represented in Luminal-A subtype compared to PR+CR.
NR were significantly less represented in Ki67>14% and HR-/HER2+ compared to PR+CR (non-significant trend).
No statistical difference on histological grade between NR and PR+CR was observed. Multi-parametric prediction Computation parameters for texture analysis were:...
The main result of this study is that a multi-parametric model based on textons only,
without the additional contribution of morphologic,
biologic or DCE-MRI parameters,
was able to predict non-response to NAC with a good performance level. Texture analysis allows assessing the spatial distribution of the grey levels in the MR image of which distribution results from underlying structural properties of tissues affected by the disease processes; a concept which has been validated by...
1. Kaufmann M,
von Minckwitz G,
Senn HJ (2003).
International expert panel on the use of primary (preoperative) systemic treatment of operable breast cancer: review and recommendations. J Clin Oncol 21: 2600-8.
2. Heys SD,
Eremin O (2002).
Neoadjuvant docetaxel in breast...