Top

European Radiology

Published in:

01-10-2010 | Breast

Neoadjuvant chemotherapy for breast cancer: correlation between the baseline MR imaging findings and responses to therapy

Authors: Takayoshi Uematsu, Masako Kasami, Sachiko Yuen

Published in: European Radiology | Issue 10/2010

Abstract

Objective:

To retrospectively evaluate the magnetic resonance (MR) imaging findings of breast cancer before neoadjuvant chemotherapy (NAC) and to compare findings of chemosensitive breast cancer with those of chemoresistant breast cancer.

Methods:

The MR imaging findings before NAC in 120 women undergoing NAC were reviewed. The MR imaging findings were compared with the pathological findings and responses.

Results:

A complete response (pCR) and marked response were achieved in 12 and 35% of 120 breast cancers in 120 women respectively. Breast cancers with a pCR or marked response were classified as chemosensitive breast cancer. The remaining 64 breast cancers (53%) were classified as chemoresistant breast cancer. Large tumour size, a lesion without mass effect, and very high intratumoural signal intensity on T2-weighted MR images were significantly associated with chemoresistant breast cancer. Lesions with mass effect and washout enhancement pattern were significantly associated with chemosensitive breast cancer. Areas with very high intratumoural signal intensity on T2-weighted images corresponded pathologically to areas of intratumoural necrosis.

Conclusion:

Several MR imaging features of breast cancer before NAC can help predict the efficacy of NAC.

Rosen EL, Blackwell KL, Baker JA et al (2003) Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy. AJR Am J Roentgenol 181:1275–1282PubMed

Partridge SC, Gibbs JE, Lu Y, Esserman LJ, Sudilovsky D, Hylton NM (2002) Accuracy of MR imaging for revealing residual breast cancer in patients who have undergone neoadjuvant chemotherapy. AJR Am J Roentgenol 179:1193–1199PubMed

Londero V, Bazzocchi M, Frate CD et al (2004) Locally advanced breast cancer: comparison of mammography, sonography and MR imaging in evaluation of residual disease in women receiving neoadjuvant chemotherapy. Eur Radiol 14:1371–1379CrossRefPubMed

Balu-Maestro C, Chapellier C, Bleuse A, Chanalet I, Chauvel C, Largillier R (2002) Imaging in evaluation of response to neoadjuvant breast cancer treatment benefits of MRI. Breast Cancer Res Treat 72:145–152CrossRefPubMed

Akazawa K, Tamaki Y, Taguchi T et al (2006) Preoperative evaluation of residual tumor extent by three-dimensional magnetic resonance imaging in breast cancer patients treated with neoadjuvant chemotherapy. Breast J 12:130–137CrossRefPubMed

Abraham DC, Jones RC, Jones SE et al (1996) Evaluation of neoadjuvant chemotherapeutic response of locally advanced breast cancer by magnetic resonance imaging. Cancer 78:91–100CrossRefPubMed

Yeh E, Slanetz P, Kopans DB et al (2005) Prospective comparison of mammography, sonography, and MRI in patients undergoing neoadjuvant chemotherapy for palpable breast cancer. AJR Am J Roentgenol 184:868–877PubMed

Esserman L, Kaplan E, Partridge S et al (2001) MRI phenotype is associated with response to doxorubicin and cyclophosphamide neoadjuvant chemotherapy in stage 3 breast cancer. Ann Surg Oncol 8:549–559CrossRefPubMed

Martincich L, Montemurro F, Cirillo S et al (2003) Role of magnetic resonance imaging in the prediction of tumor response in patients with locally advanced breast cancer receiving neoadjuvant chemo-therapy. Radiol Med 106:51–56PubMed

10.

Murata Y, Ogawa Y, Yoshida S et al (2004) Utility of initial MRI for predicting extent of residual disease after neoadjuvant chemotherapy: analysis of 70 breast cancer patients. Oncol Rep 12:1257–1262PubMed

11.

Ikeda DM, Hylton NM, Kuhl CK et al (2003) Breast imaging reporting and data system, BI-RADS: MRI, 4th edn. American College of Radiology, Reston, VA

12.

Egan RL (1982) Multicentric breast carcinomas: clinical-radiographic-pathologic whole organ studies and 10-year survival. Cancer 49:1123–1130CrossRefPubMed

13.

Kurosumi M, Akashi-Tanaka S, Akiyama F et al (2008) Histopathological criteria for assessment of therapeutic response in breast cancer (2007 version). Breast Cancer 15:5–7CrossRefPubMed

14.

Esserman L, Hylton N, George T, Weidner N (1999) Contrast-enhanced magnetic resonance imaging to assess tumor histopathology and angiogenesis in breast carcinoma. Breast J 5:13–21CrossRefPubMed

15.

Rieber A, Zeitler H, Rosenthal H et al (1997) MRI of breast cancer: influence of chemotherapy on sensitivity. Br J Radiol 70:452–458PubMed

16.

Craciunescu OI, Blackwell KL, Jones EL et al (2009) DCE-MRI parameters have potential to predict response of locally advanced breast cancer patients to neoadjuvant chemotherapy and hyperthermia: a pilot study. Int J Hyperthermia 25:405–415CrossRefPubMed

17.

Semple SI, Staff RT, Heys SD et al (2006) Baseline MRI delivery characteristics predict change in invasive ductal breast carcinoma PET metabolism as a result of primary chemotherapy administration. Ann Oncol 17:1393–1398CrossRefPubMed

18.

Fisher ER, Anderson S, Redmond C, Fisher B (1993) Pathologic findings from the National Surgical Adjuvant Breast Project B-06. 10-year pathologic and clinical prognostic discriminants. Cancer 71:2507–2514CrossRefPubMed

19.

Jimenez RE, Wallis T, Visscher DW (2001) Centrally necrotizing carcinoma of the breast: a distinct histologic subtype with aggressive clinical behavior. Am J Surg Pathol 25:331–337CrossRefPubMed

20.

Leek RD, Landers RJ, Harris AL, Lewis CE (1999) Necrosis correlates with high vascular density and focal macrophage infiltration in invasive carcinoma of the breast. Br J Cancer 79:991–995CrossRefPubMed

21.

Metz S, Daldrup-Link HE, Richter T et al (2003) Detection and quantification of breast tumor necrosis with MR imaging: value of the necrosis-avid contrast agent gadophrin-3. Acad Radiol 10:484–490CrossRefPubMed

22.

Uematsu T, Kasami M, Yuen S (2009) Triple-negative breast cancer: correlation between MR imaging and pathologic findings. Radiology 250:638–647CrossRefPubMed

23.

Tamura N, Hasebe T, Okada N et al (2009) Tumor histology in lymph vessels and lymph nodes for the accurate prediction of outcome among breast cancer patients treated with neoadjuvant chemotherapy. Cancer Sci 100:1823–1833CrossRefPubMed

24.

Tubiana-Hulin M, Stevens D, Lasry S et al (2006) Response to neoadjuvant chemotherapy in lobular and ductal breast carcinomas: a retrospective study on 860 patients from one institution. Ann Oncol 17:1228–1233CrossRefPubMed

25.

Cristofanilli M, Gonzalez-Angulo A, Sneige N et al (2005) Invasive lobular carcinoma classic type: response to primary chemotherapy and survival outcomes. J Clin Oncol 23:41–48CrossRefPubMed

26.

Chen JH, Feig B, Agrawal G et al (2008) MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy. Cancer 112:17–26CrossRefPubMed

Title: Neoadjuvant chemotherapy for breast cancer: correlation between the baseline MR imaging findings and responses to therapy
Authors: Takayoshi Uematsu
Masako Kasami
Sachiko Yuen
Publication date: 01-10-2010
Publisher: Springer-Verlag
Published in: European Radiology / Issue 10/2010
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-010-1813-8

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Neoadjuvant chemotherapy for breast cancer: correlation between the baseline MR imaging findings and responses to therapy

Abstract

Objective:

Methods:

Results:

Conclusion:

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Objective:

Methods:

Results:

Conclusion:

Please log in to get access to this content

Other articles of this Issue 10/2010

Outcomes of follow-up CT for small (5–10-mm) arterially enhancing nodules in the liver and risk factors for developing hepatocellular carcinoma in a surveillance population

Single breath-hold magnetic resonance cine imaging for fast assessment of global and regional left ventricular function in clinical routine

An exploratory pilot study into the association between microcirculatory parameters derived by MRI-based pharmacokinetic analysis and glucose utilization estimated by PET-CT imaging in head and neck cancer

High-relaxivity contrast-enhanced magnetic resonance neuroimaging: a review

Percutaneous isolated liver perfusion with occlusion balloons and a catheter-based stent-graft-like perfusion device: an experimental study in a porcine model

Does digital mammography in a decentralized breast cancer screening program lead to screening performance parameters comparable with film-screen mammography?