Magnetic resonance imaging in breast cancer treated with neoadjuvant chemotherapy: Radiologic–pathologic correlation of the response and disease-free survival depending on molecular subtype

• Published in: Radiología (English ed.) Vol. 56; no. 6; pp. 524 - 532
• Main Authors: Cruz Ciria, S, Jiménez Aragón, F, García Mur, C, Esteban Cuesta, H, Gros Bañeres, B
• Format: Journal Article
• Language: English
• Published: Elsevier España 01.11.2014
• Subjects: Breast cancer; Cáncer de mama; Imagen por resonancia magnética; Magnetic resonance imaging; Molecular subtypes; Neoadjuvant chemotherapy; Quimioterapia neoadyuvante; Radiologic response; Radiology; Respuesta radiológica; Subtipos moleculares; Supervivencia; Survival; Neoadjuvant chemotherapy; Radiologic response; Molecular subtypes; Respuesta radiológica; Quimioterapia neoadyuvante; Magnetic resonance imaging; Cáncer de mama; Imagen por resonancia magnética; Breast cancer; Survival; Subtipos moleculares; Supervivencia
• ISSN: 2173-5107; 2173-5107
• DOI: 10.1016/j.rxeng.2012.10.002

Abstract Objectives To evaluate the radiologic and pathologic responses to neoadjuvant chemotherapy and their correlation in the molecular subtypes of breast cancer and to analyze their impact in disease-free survival. Materials and methods We included 205 patients with breast cancer treated with neoadjuvant chemotherapy. We evaluated the radiologic response by comparing MRI images acquired before and after chemotherapy. The pathologic response was classified on the Miller and Payne scale. For each subtype (HER2+, TN, luminal A, luminal B HER2−, and luminal B HER2+), we used the χ2 test, Student's t -test, ANOVA, and Kendall's Tau-b to evaluate the radiologic response and the pathologic response, the radiologic–pathologic correlation, and the disease-free survival. Results The subtypes HER2+ (62.1%) and TN (45.2%) had higher rates of complete radiologic response. The pathologic response was 65.5% in the HER2+ subtype, 38.1% in the TN subtype, 2.6% in the luminal A subtype, 8.2% in the luminal B HER2− subtype, and 31% in the luminal B HER2+ subtype. The rate of radiologic–pathologic correlation was significant in all subtypes, higher in TN and HER2 (Tau-b coefficients 0.805 and 0.717, respectively). Disease-free survival was higher in HER2+ (91.9 ± 3.3 months) and lower in TN (69.5 ± 6.3 months), with significant differences between the cases with poor and good radiologic responses ( p = 0.040). Survival was greater in cases with good radiologic response, except in cases with luminal A subtype. Conclusion MRI can be a useful tool that provides information about the evolution of breast cancer treated with neoadjuvant chemotherapy, which varies with the immunohistochemical subtype.