Annals of Surgical Oncology

, Volume 8, Issue 6, pp 549–559

MRI Phenotype Is Associated With Response to Doxorubicin and Cyclophosphamide Neoadjuvant Chemotherapy in Stage III Breast Cancer

  • Laura Esserman
  • Elizabeth Kaplan
  • Savanah Partridge
  • Debasish Tripathy
  • Hope Rugo
  • John Park
  • Shelley Hwang
  • Henry Kuerer
  • Dan Sudilovsky
  • Ying Lu
  • Nola Hylton
Original Articles

DOI: 10.1007/s10434-001-0549-8

Cite this article as:
Esserman, L., Kaplan, E., Partridge, S. et al. Ann Surg Oncol (2001) 8: 549. doi:10.1007/s10434-001-0549-8
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Abstract

Background: The preferred management for women with stage II or locally advanced breast cancer (LABC) is neoadjuvant chemotherapy. Pathologic response to chemotherapy has been shown to be an excellent predictor of outcome. Surrogates that can predict pathologic response and outcome will fuel future changes in management. Magnetic resonance imaging (MRI) demonstrates that patients with LABC have distinct tumor patterns. We investigated whether or not these patterns predict response to therapy.

Methods: Thirty-three women who received neoadjuvant doxorubicin and cyclophosphamide chemotherapy for 4 cycles and serial breast MRI scans before and after therapy were evaluated for this study. Response to therapy was measured by change in the longest diameter on the MRI.

Results: Five distinct imaging patterns were identified: circumscribed mass, nodular tissue infiltration diffuse tissue infiltration, patchy enhancement, and septal spread. The likelihood of a partial or complete response as measured by change in longest diameter was 77%, 37.5%, 20%, and 25%, respectively.

Conclusions: MRI affords three-dimensional characterization of tumors and has revealed distinct patterns of tumor presentation that predict response. A multisite trial is being planned to combine imaging and genetic information in an effort to better understand and predict response and, ultimately, to tailor therapy and direct the use of novel agents.

Key Words

Magnetic resonance imagingNeoadjuvant chemotherapyLocally advanced breast cancer

Copyright information

© The Society of Surgical Oncology, Inc. 2001

Authors and Affiliations

  • Laura Esserman
    • 1
    • 4
    • 6
  • Elizabeth Kaplan
    • 1
  • Savanah Partridge
    • 2
  • Debasish Tripathy
    • 5
  • Hope Rugo
    • 5
  • John Park
    • 5
  • Shelley Hwang
    • 1
  • Henry Kuerer
    • 1
  • Dan Sudilovsky
    • 3
  • Ying Lu
    • 4
  • Nola Hylton
    • 4
  1. 1.Department of SurgeryUniversity of CaliforniaSan Francisco
  2. 2.Department of BioengineeringUniversity of CaliforniaSan Francisco
  3. 3.Department of PathologyUniversity of CaliforniaSan Francisco
  4. 4.Department of RadiologyUniversity of CaliforniaSan Francisco
  5. 5.Department of MedicineUniversity of CaliforniaSan Francisco
  6. 6.San Francisco