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. 2020 Mar-Apr;34(2):909-915.
doi: 10.21873/invivo.11857.

Role of Magnetic Resonance Imaging in the Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy

Giorgia Pasquero  1 , Alessandra Surace  2 , Antonio Ponti  3 , Massimiliano Bortolini  4 , Donatella Tota  5 , Maria Piera Mano  3 , Riccardo Arisio  6 , Chiara Benedetto  1 , Maria Grazia Baù  7
Affiliations

Role of Magnetic Resonance Imaging in the Evaluation of Breast Cancer Response to Neoadjuvant Chemotherapy

Giorgia Pasquero et al. In Vivo. 2020 Mar-Apr.

Abstract

Background/aim: The aim of the study was to evaluate whether residual tumor assessment by magnetic resonance imaging (MRI) after neoadjuvant chemotherapy (NACT) is fundamental for a successive surgical strategy.

Patients and methods: We collected 55 MRIs performed after NACT.

Results: Pathological response rate was 20%. MRI's sensitivity, specificity, PPV and NPV were 50%, 88%, 54% and 86%, respectively. We observed a high variability between the different subgroups, with high number of false positives in luminal A/B tumors. Triple negative and HER2+ tumors had almost the same specificity and sensitivity (81% and 50%). Nevertheless, in the HER2+ group, PPV was greater than that in the triple negative group (71% and 33% respectively) and the NPV of the triple negative group was greater than that of the HER2+ one (90% and 64%, respectively). Statistical analysis showed a weak but significant correlation between MRI and pathological assessment of residual tumor dimension.

Conclusion: The present study, confirms literature data about MRI accuracy in diagnosing HER2+ and triple negative tumors, but suggests caution in case of luminal tumors' evaluation.

Keywords: Magnetic resonance imaging; breast cancer subtypes; breast neoplasms; imaging complete response (iCR); neoadjuvant chemotherapy; pathological complete response (pCR).

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Conflict of interest statement

The Authors have no conflicts of interest to declare regarding this study.

Figures

Figure 1
Figure 1. Breast cancer MRI appearances. A: Luminal A/B tumor: mass with irregular margins. B: HER2+ tumor: mass with regular margins. C: Triple negative tumor: mass with intra-tumoral necrosis.
Figure 2
Figure 2. Sample selection.
Figure 3
Figure 3. Correlation between residual tumor dimension assessment (MRI vs. pathology) (Pearson r=0.48, p=0.01).
Figure 4
Figure 4. Correlation between residual tumor dimension assessment (MRI vs. pathology) in each tumor subgroup. A: Luminal A/B tumors (Pearson r=0.23, p=0.42). B: Triple negative tumors (Pearson r=0.85, p=0.06). C: HER2+ tumors (Pearson r=0.67, p=0.07).
See this image and copyright information in PMC

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