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Analysis of Factors that Influence the Accuracy of Magnetic Resonance Imaging for Predicting Response after Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to evaluate the accuracy of breast magnetic resonance imaging (MRI) to predict residual lesion size after neoadjuvant chemotherapy (NAC) and to determine the factors that influence the accuracy of response prediction.

Methods

This study comprised 166 patients who underwent MRI before and after NAC, but before surgery. The longest diameter of the residual cancer was measured using MRI and correlated with pathologic findings. Patients were further divided into subgroups according to various radiologic and histopathologic factors. Pathologic complete response (pCR) was defined as the absence of residual invasive cancer cells. The Pearson correlation was used to correlate tumor size as determined by MRI and pathology, and the Mann-Whitney U test and Kruskal-Wallis test were used to compare MRI-pathologic size discrepancies according to various clinical, histopathologic factors, and MRI findings.

Results

Of the 166 women, 40 achieved pCR. The overall sensitivity, specificity, and accuracy for diagnosing invasive residual disease by using MRI were 96, 65, and 89 %, respectively. The Pearson’s correlation coefficient between the tumor sizes measured using MRI and pathology was 0.749 (P < 0.001). The size discrepancy was significantly greater in patients with estrogen receptor-positive cancer (P = 0.037), in cancers with low nuclear grade (P = 0.007), and in cancers shown as diffuse non-mass–like enhancement on MRI (P = 0.001).

Conclusions

Size prediction is less accurate in cases with estrogen receptor-positive breast cancer, low nuclear grade, and diffuse non-mass–like enhancement on initial MRI.

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Authors and Affiliations

  1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Eun Sook Ko MD, Boo-Kyung Han MD, PhD, Eun Young Ko MD, PhD, Jung Hee Shin MD, PhD & Soo Yeon Hahn MD

  2. Department of Regional Cardiovascular Center, Dong-A University Hospital, Pusan, Korea

    Rock Bum Kim MD, PhD

  3. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Seok Jin Nam MD, PhD, Jeong Eon Lee MD, PhD & Se Kyung Lee MD, PhD

  4. Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

    Young-Hyuck Im MD, PhD & Yeon Hee Park MD, PhD

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  1. Eun Sook Ko MD
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  2. Boo-Kyung Han MD, PhD
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  7. Seok Jin Nam MD, PhD
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  8. Jeong Eon Lee MD, PhD
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  9. Se Kyung Lee MD, PhD
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  10. Young-Hyuck Im MD, PhD
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  11. Yeon Hee Park MD, PhD
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Correspondence to Boo-Kyung Han MD, PhD.

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Ko, E.S., Han, BK., Kim, R.B. et al. Analysis of Factors that Influence the Accuracy of Magnetic Resonance Imaging for Predicting Response after Neoadjuvant Chemotherapy in Locally Advanced Breast Cancer. Ann Surg Oncol 20, 2562–2568 (2013). https://doi.org/10.1245/s10434-013-2925-6

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  • DOI: https://doi.org/10.1245/s10434-013-2925-6

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