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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2016

01-04-2016 | Breast Oncology

Residual Mammographic Microcalcifications and Enhancing Lesions on MRI After Neoadjuvant Systemic Chemotherapy for Locally Advanced Breast Cancer: Correlation with Histopathologic Residual Tumor Size

Authors: Young-Seon Kim, MD, Jung Min Chang, MD, PhD, Hyeong-Gon Moon, MD, Joongyub Lee, MD, PhD, Sung Ui Shin, MD, Woo Kyung Moon, MD, PhD

Published in: Annals of Surgical Oncology | Issue 4/2016

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Abstract

Purpose

To evaluate the accuracy of residual microcalcifications on mammogram (MG) in predicting the extent of the residual tumor after neoadjuvant systemic treatment (NST) in patients with locally advanced breast cancer and to evaluate factors affecting the accuracy of MG microcalcifications using magnetic resonance imaging (MRI) as a reference.

Methods

The patients who underwent NST and showed suspicious microcalcifications on MG comprised our study population. Clinicopathologic and imaging (MG, MRI) findings were investigated. Agreement between image findings and pathology was assessed and factors affecting the discrepancy were analyzed.

Results

Among 207 patients, 196 had residual invasive ductal carcinoma or ductal carcinoma-in-situ (mean size, 3.78 cm). The overall agreement of residual microcalcifications on MG predicting residual tumor extents was lower than MRI in all tumor subtypes (intraclass correlation coefficient [ICC] = 0.368 and 0.723, p < 0.0001). The agreement of residual MG microcalcifications and pathology was highest in HR+/HER2+ tumors and lowest in the triple-negative tumors (ICC = 0.417 and 0.205, respectively). Multivariate linear regression analysis revealed that a size discrepancy between microcalcifications and histopathology was correlated with molecular subtype (p = 0.005). In HR+/HER2− and triple-negative subtypes, the mean extents of residual microcalcification were smaller than residual cancer, and overestimation of tumor extent was more frequent in HR+/HER2+ and HR−/HER2+ tumors.

Conclusions

The extent of microcalcifications on MG after NST showed an overall lower correlation with the extent of the pathologic residual tumor than enhancing lesions on MRI. The accuracy of residual tumor evaluation after NST with MG and MRI is affected by their molecular subtype.
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Metadata
Title
Residual Mammographic Microcalcifications and Enhancing Lesions on MRI After Neoadjuvant Systemic Chemotherapy for Locally Advanced Breast Cancer: Correlation with Histopathologic Residual Tumor Size
Authors
Young-Seon Kim, MD
Jung Min Chang, MD, PhD
Hyeong-Gon Moon, MD
Joongyub Lee, MD, PhD
Sung Ui Shin, MD
Woo Kyung Moon, MD, PhD
Publication date
01-04-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-015-4993-2

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