Postchemotherapy MRI overestimates residual disease compared with histopathology in responders to neoadjuvant therapy for locally advanced breast cancer.
Unlabelled: The utility of breast magnetic resonance imaging in patients receiving neoadjuvant chemotherapy is not well defined. We compared serial magnetic resonance imaging examinations with histologic posttreatment examinations in patients treated with primary chemotherapy for locally advanced br...
| Published in: | Cancer Journal Vol. 12; no. 3; pp. 212 - 222 |
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| Main Authors: | , , , , , , , , , , , , , , , , , |
| Format: | research Journal Article |
| Published: |
Lippincott Williams & Wilkins
May/Jun2006
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106199928&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106199928 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15289117 4U5 jtl: Cancer Journal issn: 15289117 maglogo: N pubinfo: dt: May/Jun2006 vid: 12 iid: 3 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 106199928 NLM16803680 2009208316 10.1097/00130404-200605000-00010 NLM16803680 106199928 ppf: 212 ppct: 10 formats: fmt: @attributes: type: P tig: atl: Postchemotherapy MRI overestimates residual disease compared with histopathology in responders to neoadjuvant therapy for locally advanced breast cancer. aug: au: Kwong MS Chung GG Horvath LJ Ward BA Hsu AD Carter D Tavassoli F Haffty B Burtness BA Kwong, Myron S Chung, Gina G Horvath, Laura J Ward, Barbara A Hsu, Arlene D Carter, Darryl Tavassoli, Fatteneh Haffty, Bruce Burtness, Barbara A affil: Section of Medical Oncology, Yale University School of Medicine, New Haven, Connecticut 06520, USA sug: subj: Antineoplastic Agents, Combined Therapeutic Use Breast Neoplasms Diagnosis Breast Neoplasms Drug Therapy Magnetic Resonance Imaging Methods Adult Chemotherapy, Adjuvant Doxorubicin Administration and Dosage Female Granulocyte Colony-Stimulating Factor Administration and Dosage Hydrocarbons Administration and Dosage Mastectomy Middle Age Neoadjuvant Therapy Neoplasm Invasiveness Neoplastic Processes Prognosis Survival Treatment Outcomes Human Adult: 19-44 years Middle Aged: 45-64 years Female ab: Unlabelled: The utility of breast magnetic resonance imaging in patients receiving neoadjuvant chemotherapy is not well defined. We compared serial magnetic resonance imaging examinations with histologic posttreatment examinations in patients treated with primary chemotherapy for locally advanced breast cancer.Patients and Methods: Eligible patients with locally advanced breast cancer received doxorubicin 60 mg/m(2) and docetaxel 60 mg/m(2) (with granulocyte colony stimulating factor support) every 14 days for a maximum of six cycles. Breast magnetic resonance imaging was performed at baseline and repeated every two cycles. Surgery (either local excision or mastectomy) was performed after six cycles in responding or stable patients. Residual tumor size on pathology and preoperative magnetic resonance imaging was compared; concordance was defined as a < or = 0.5-cm difference.Results: To date, three of 17 enrolled subjects (17.6%) attained pathologic complete response, and three additional patients attained near pathologic complete response, with residual foci of < or = 1 mm. Of these six patients, only one was disease-free by magnetic resonance imaging. Discordance between magnetic resonance imaging findings and pathologic evaluation was found in four of six patients (66.6%) who obtained pathologic complete response or near pathologic complete response. In the three patients in whom four axillary lesions were followed with magnetic resonance imaging, discordance was found in all four lesions, with magnetic resonance imaging overestimating pathologic disease in all cases.Discussion: Our findings caution that magnetic resonance imaging may frequently overestimate residual invasive carcinoma after neoadjuvant chemotherapy. These results contradict previous studies suggesting that postchemotherapy magnetic resonance imaging may underestimate residual cancer. The use of magnetic resonance imaging in evaluating response to therapy in locally advanced breast cancer should be further studied. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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