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

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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.

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Authors and Affiliations

  1. Department of Surgery, University of California, San Francisco, California

    Laura Esserman MD, Elizabeth Kaplan BA, Shelley Hwang MD & Henry Kuerer MD

  2. Department of Bioengineering, University of California, San Francisco, California

    Savanah Partridge BS

  3. Department of Pathology, University of California, San Francisco, California

    Dan Sudilovsky MD

  4. Department of Radiology, University of California, San Francisco, California

    Laura Esserman MD, Ying Lu PhD & Nola Hylton PhD

  5. Department of Medicine, University of California, San Francisco, California

    Debasish Tripathy MD, Hope Rugo MD & John Park MD

  6. 2356 Sutter Street, 6th Floor, San Francisco, CA, 94115

    Laura Esserman MD

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  1. Laura Esserman MD
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  2. Elizabeth Kaplan BA
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  3. Savanah Partridge BS
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  4. Debasish Tripathy MD
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  7. Shelley Hwang MD
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  8. Henry Kuerer MD
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  9. Dan Sudilovsky MD
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  11. Nola Hylton PhD
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Correspondence to Laura Esserman MD.

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Esserman, L., Kaplan, E., Partridge, S. et al. MRI Phenotype Is Associated With Response to Doxorubicin and Cyclophosphamide Neoadjuvant Chemotherapy in Stage III Breast Cancer. Ann Surg Oncol 8, 549–559 (2001). https://doi.org/10.1007/s10434-001-0549-8

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  • DOI: https://doi.org/10.1007/s10434-001-0549-8

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