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Magnetic resonance examination to predict pathological complete response following neoadjuvant chemotherapy: when is it appropriate for HER2-positive and triple-negative breast cancers?

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Abstract

Background

To clarify appropriate timing for magnetic resonance examination to predict pathological complete response to neoadjuvant chemotherapy for patients with human epidermal growth factor receptor 2 (HER2)-positive and triple-negative breast cancers in terms of tumor volume change.

Methods

Between September 2009 and December 2014, 113 women with HER2-positive (n = 51) and triple-negative (n = 62) invasive breast cancers undergoing neoadjuvant chemotherapy were enrolled. Patients with HER2-positive tumors underwent neoadjuvant chemotherapy with an anthracycline-based regimen followed by docetaxel with trastuzumab. Patients with triple-negative tumors underwent neoadjuvant chemotherapy with anthracycline-based (first in most cases) and taxane-based regimens. Magnetic resonance imaging was performed before neoadjuvant chemotherapy, between the regimens (midpoint examination), and after neoadjuvant chemotherapy (final examination). Response ratio of tumor volume was calculated and receiver-operating characteristic analyses for them for both subtypes were performed at the midpoint and final examinations.

Results

Twenty-eight women with HER2-positive tumors (54.9 %) and 29 women with triple-negative tumors (46.8 %) had pathological complete response. The response ratios were better in cases with pathological complete response than in those without (p = 0.0341, p < 0.0001). The area under the curve at the final examination was higher than that at the midpoint examination for HER2-positive tumors (p = 0.039); whereas for the triple-negative tumors, no significant difference between the two examinations was shown (p = 0.5218).

Conclusions

Magnetic resonance examination to predict pathological complete response would be feasible after completion of a regimen including trastuzumab for HER2-positive tumors and at the midpoint of neoadjuvant chemotherapy for triple-negative tumors.

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Acknowledgments

We thank Tsuneo Yamashiro for his help in the statistical design of the study.

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Authors and Affiliations

  1. Department of Radiology, Breast and Imaging Center, St. Marianna University School of Medicine, 6-7-2 Manpukuji, Asao-ku, Kawasaki, Kanagawa, 215-0004, Japan

    Satoko Okamoto & Yoshihide Kanemaki

  2. Department of Radiology, Yokohama City Seibu Hospital, St. Marianna University School of Medicine, Kanagawa, Japan

    Takayuki Yamada

  3. Department of Breast Surgical Oncology, St. Marianna University School of Medicine, Kanagawa, Japan

    Yasuyuki Kojima & Koichiro Tsugawa

  4. Department of Radiology, St. Marianna University School of Medicine, Kanagawa, Japan

    Yasuo Nakajima

Authors
  1. Satoko Okamoto
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  2. Takayuki Yamada
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  3. Yoshihide Kanemaki
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  4. Yasuyuki Kojima
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  5. Koichiro Tsugawa
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  6. Yasuo Nakajima
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Correspondence to Satoko Okamoto.

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The authors declare that they have no conflict of interest.

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Okamoto, S., Yamada, T., Kanemaki, Y. et al. Magnetic resonance examination to predict pathological complete response following neoadjuvant chemotherapy: when is it appropriate for HER2-positive and triple-negative breast cancers?. Breast Cancer 23, 789–796 (2016). https://doi.org/10.1007/s12282-015-0642-7

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  • DOI: https://doi.org/10.1007/s12282-015-0642-7

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