Affiliations: [a] Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, United Kingdom | [b] Department of Breast Radiology, University Hospitals of North Midlands, Stoke-on-Trent, United Kingdom
Correspondence:
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Corresponding author: Soni Soumian, Department of Breast Surgery, University Hospitals of North Midlands, Stoke-on-Trent, ST4 6QG, United Kingdom. Tel.: +44 7884050854; E-mail: soni.soumian@uhnm.nhs.uk
Note: [†] Same contribution as first author.
Abstract: BACKGROUND AND OBJECTIVES:MRI is generally performed to assess response to Neo-adjuvant systemic therapy (NAST) in breast cancer. OBJECTIVE:To assess role of MRI in determining the probability of having residual disease in patients undergoing NAST. We also evaluated synchronous cancers diagnosed following MRI. METHODS:This is a retrospective study which included all patients who had pre-and post-NAST MRI between June 2014 and December 2019. Data on demographics, tumour characteristics and pathology were collected and analysed. Pre- and post-MRI probability were calculated and depicted on nomograms. RESULTS:The study included 205 patients. Overall pre-MRI probability of having residual disease was 55% (OR:1.2). The post-MRI probability was 78% (95% CI 72–83%; OR:3.5) if MRI showed residual disease and 23% (95% CI 16–31%, OR:0.3) if imaging showed complete response. The absolute benefit was higher in TNBC and HR-HER2. Additional cancers were identified in 8.78% of patients. CONCLUSION:MRI is beneficial in evaluating response to NAST specifically in TNBC and HR-HER2 cancers. Pre- and post-MRI probabilities of residual disease depicted on nomograms are a useful tool for clinicians. MRI can potentially impact the treatment decisions by identification of synchronous cancers.
Keywords: Breast cancer, magnetic resonance imaging, neoadjuvant, nomogram, residual disease
DOI: 10.3233/BD-210023
Journal: Breast Disease, vol. 41, no. 1, pp. 165-173, 2022
