Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy

被引:42
作者
Ballesio, Laura [1 ,2 ]
Gigli, Silvia [1 ,2 ]
Di Pastena, Francesca [1 ,2 ]
Giraldi, Guglielmo [3 ]
Manganaro, Lucia [1 ,2 ]
Anastasi, Emanuela [4 ]
Catalano, Carlo [1 ,2 ]
机构
[1] Sapienza Univ Rome, Dept Radiol Oncol & Anatomopathol Sci, Rome, Italy
[2] Umberto I Hosp, Rome, Italy
[3] Sapienza Univ Rome, Dept Publ Hlth & Infect Dis, Rome, Italy
[4] Sapienza Univ Rome, Dept Mol Med, Rome, Italy
关键词
Tumor biological subtypes; breast magnetic resonance imaging; neoadjuvant chemotherapy; shrinkage pattern; tumor regression; GRADING SYSTEM; ACCURACY; MRI; ANGIOGENESIS;
D O I
10.1177/1010428317694540
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The objective of this study is to analyze magnetic resonance imaging shrinkage pattern of tumor regression after neoadjuvant chemotherapy and to evaluate its relationship with biological subtypes and pathological response. We reviewed the magnetic resonance imaging studies of 51 patients with single mass-enhancing lesions (performed at time 0 and at the II and last cycles of neoadjuvant chemotherapy). Tumors were classified as Luminal A, Luminal B, HER2+, and Triple Negative based on biological and immunohistochemical analysis after core needle biopsy. We classified shrinkage pattern, based on tumor regression morphology on magnetic resonance imaging at the II cycle, as concentric, nodular, and mixed. We assigned a numeric score (0: none; 1: low; 2: medium; 3: high) to the enhancement intensity decrease. Pathological response on the surgical specimen was classified as complete (grade 5), partial (grades 4-3), and non- response (grades 1-2) according to Miller and Payne system. Fisher test was used to relate shrinkage pattern with biological subtypes and final pathological response. Seventeen patients achieved complete response, 25 partial response, and 9 non-response. A total of 13 lesions showed nodular pattern, 20 concentric, and 18 mixed. We found an association between concentric pattern and HER2+ (p < 0.001) and mixed pattern and Luminal A lesions (p < 0.001). We observed a statistical significant correlation between concentric pattern and complete response (p < 0.001) and between mixed pattern and non-response (p = 0.005). Enhancement intensity decrease 3 was associated with complete response (p < 0.001). Shrinkage pattern and enhancement intensity decrease may serve as early response indicators after neoadjuvant chemotherapy. Shrinkage pattern correlates with tumor biological subtypes.
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页数:8
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