Journal article
Pre-treatment MRI tumor features and post-treatment mammographic findings: may they contribute to refining the prediction of pathologic complete response in post-neoadjuvant breast cancer patients with radiologic complete response on MRI?
European radiology, Vol.32(3), pp.1663-1675
03/01/2022
DOI: 10.1007/s00330-021-08290-1
PMID: 34716780
Abstract
Purpose
Radiologic complete response (rCR) in breast cancer patients after neoadjuvant chemotherapy (NAC) does not necessarily correlate with pathologic complete response (pCR), a marker traditionally associated with better outcomes. We sought to verify if data extracted from two important steps of the imaging workup (tumor features at pre-treatment MRI and post-treatment mammographic findings) might assist in refining the prediction of pCR in post-NAC patients showing rCR.
Methods
A total of 115 post-NAC women with rCR on MRI (2010–2016) were retrospectively assessed. Pre-treatment MRI (lesion morphology, size, and distribution) and post-treatment mammographic findings (calcification, asymmetry, mass, architectural distortion) were assessed, as well as clinical and molecular variables. Bivariate and multivariate analyses evaluated correlation between such variables and pCR. Post-NAC mammographic findings and their correlation with ductal in situ carcinoma (DCIS) were evaluated using Pearson’s correlation.
Results
Tumor distribution at pre-treatment MRI was the only significant predictive imaging feature on multivariate analysis, with multicentric lesions having lower odds of pCR (
p
= 0.035). There was no significant association between tumor size and morphology with pCR. Mammographic residual calcifications were associated with DCIS (
p
= 0.009). The receptor subtype remained as a significant predictor, with HR-HER2 + and triple-negative status demonstrating higher odds of pCR on multivariate analyses.
Conclusions
Multicentric lesions on pre-NAC MRI were associated with a lower chance of pCR in post-NAC rCR patients. The receptor subtype remained a reliable predictor of pCR. Residual mammographic calcifications correlated with higher odds of malignancy, making the correlation between mammography and MRI essential for surgical planning.
Key Points
•
The presence of a multicentric lesion on pre-NAC MRI, even though the patient reaches a radiologic complete response on MRI, is associated with a lower chance of pCR.
•
Molecular status of the tumor remained the only significant predictor of pathologic complete response in such patients in the present study.
•
Post-neoadjuvant residual calcifications found on mammography were related to higher odds of residual malignancy, making the correlation between mammography and MRI essential for surgical planning.
Details
- Title: Subtitle
- Pre-treatment MRI tumor features and post-treatment mammographic findings: may they contribute to refining the prediction of pathologic complete response in post-neoadjuvant breast cancer patients with radiologic complete response on MRI?
- Creators
- Bruna M. Thompson - Universidade de São PauloLuciano F. Chala - Fleury S.A.Carlos Shimizu - Universidade de São PauloMax S. Mano - Hospital Sírio-LibanêsJosé R. Filassi - Instituto do Câncer do Estado de São PauloFelipe C. Geyer - Instituto do Câncer do Estado de São PauloUlysses S. Torres - Fleury S.A.Giselle Guedes Netto de Mello - Fleury S.A.Cláudia da Costa Leite - Universidade de São Paulo
- Resource Type
- Journal article
- Publication Details
- European radiology, Vol.32(3), pp.1663-1675
- Publisher
- Springer Berlin Heidelberg
- DOI
- 10.1007/s00330-021-08290-1
- PMID
- 34716780
- ISSN
- 0938-7994
- eISSN
- 1432-1084
- Language
- English
- Date published
- 03/01/2022
- Academic Unit
- Radiology
- Record Identifier
- 9984697727402771
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