Accuracy of MRI in the Detection of Residual Breast Cancer after Neoadjuvant Chemotherapy, MONA A. ABUL-ENEIN, INAS A. KORIEN, RASHA KAMAL and MOHAMED A. HASSAN
Abstract
Background: This study investigated the role of Magnetic Resonance Imaging (MRI) in evaluation of pathologically complete response and residual tumors in patients who received Neoadjuvant Chemotherapy (NAC).
Material and Methods: Thirty patients with locally ad-vanced primary breast carcinoma, who presented at Kasr Al-Aini School of Clinical Oncology (NEMROCK) underwent contrast-enhanced MRI before and after treatment with neo-adjuvant anthracycline-based and taxane-based chemotherapy. For each patient, the maximum extent of the MRI abnormality was measured both before and after treatment. These mea-surements were subsequently compared with physical exam-ination findings and histologic results to determine the ability of MRI to accurately reveal tumor extent after neoadjuvant chemotherapy.
Results: Six patients (20%) achieved radiological CR (rCR) with complete disappearance of both breast lesions and pathological axillary lymph nodes; but only three patients (50%) of them had pCR. Three patients experienced a false positive outcome, having an rCR without a pCR, and one patient had a false negative outcome, failing to achieve an rCR but having a pCR.
Conclusion: MRI can show residual malignancy after neoadjuvant chemotherapy better than physical examination, particularly in patients who have not had a complete clinical response to therapy.