Aims and objectives
Introduction
Neoadjuvant chemotherapy has been used worldwide for advanced invasive breast cancer for recent years.
The accurate evaluation of residual disease after the therapy is necessary for subsequent mastectomy andtheassessment of chemotherapeutic effect.
Its diagnostic approach has not been discussed fully in the literature.
Aims
The aims of this study was to investigate the diagnostic performance of dynamic MR imaging in the evaluation of residual disease of breast cancer treated with neoadjuvant chemotherapy.
Methods and materials
Methods and materials
65 lesions in 62 patients (women,
28-80,
mean 56 years) with invasive breast cancer were enrolled for this study,
who were treated with neoadjuvant chemotherapy and underwent dynamic MR imaging before mastectomy from July 2011 to April 2014.
All lesions were biopsied and diagnosed as invasive breast cancer before the therapy.
Regimens of neoadjuvant chemotherapy
Weekly paclitaxel + trastuzumab → FEC; 28 patients
Weekly paclitaxel → FEC; 17 patients
FEC → weekly paclitaxel; 4 patients
Others; 13 patients
(Note.
FEC: 5-fluorouracil +...
Results
Results
Diagnostic Performance
Pathological examinations showed residual disease in 53 of the 65 lesions.
Pathological complete response rate was 18% (12/65).
15 (23%) of the 65 lesions showed no enhancement on dynamic MR images and were evaluated as having no residual disease.
10 of them had no residual disease on pathology and were correctly evaluated (negative predictive value 0.67).
50 (77%) of the 65 lesions showed enhancement on dynamic MR images and were evaluated as having residual disease.
48 of them had residual disease on...
Conclusion
Discussion
The definition of complete response has not been established and may vary with institutions.
The residue of intraductal tumors was treated as positive in the present study.
Late phase images were superior to early phase images for the depiction of residual disease.
This may be due to the decrease of blood supply subsequent to degeneration and necrosis of tumor tissues and progression of fibrosis induced by chemotherapy.
Negative predictive value was 0.67 and it was not high enough,
therefore,
dynamic MR imaging may be...
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