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Magnetic resonance imaging patterns of tumor regression in breast cancer patients after neo‐adjuvant chemotherapy, and an analysis of the influencing factors
Author(s) -
Li ManMan,
Xu Bin,
Shao Yingbo,
Liu Hui,
Du BingJie,
Yuan JunHui
Publication year - 2017
Publication title -
the breast journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.533
H-Index - 72
eISSN - 1524-4741
pISSN - 1075-122X
DOI - 10.1111/tbj.12811
Subject(s) - medicine , magnetic resonance imaging , breast cancer , chemotherapy , multivariate analysis , cancer , radiology , nuclear medicine , pathology , oncology
The objective of this study was to analyze the patterns of breast tumor shrinkage in patients after neo‐adjuvant chemotherapy ( NAC ) based on magnetic resonance imaging ( MRI ), and to evaluate the influential factors. Preoperative breast dynamic contrast‐enhanced MRI was performed on 88 patients before NAC , every 2 weeks during their chemotherapy treatment, and the week before their surgery. The MRI enhancement pattern of the primary tumors was classified into one of four categories based on BI ‐ RADS ‐ MRI : type I (postcontrast mass image), II (multiple small masses image), III (postcontrast mass image with peripheral non‐mass enhancement image), and IV (nonmass enhancement image). Multivariate regression and χ 2 test analyses were employed to establish significant associations. Two kinds of tumor regression patterns were observed: concentric shrinkage was observed in 39 lesions of 88 patients (44.3%), and nests or dendritic shrinkage was observed for the other 49 lesions (55.7%). ER +/ HER 2−, HER 2+, and type I lesions were observed in 23 (62.2%), 21 (63.6%), and 29 (60.0%) patients, respectively, out of 49 nest or dendritic shrinkage pattern lesions. Triple negative breast cancer lesions, and type II , III , and IV lesions were observed in 13 (72.2%), 9 (81.8%), 10 (62.5%), and 10 (76.9%) patients, respectively, out of 39 lesions with a concentric shrinkage pattern. Molecular subtypes (χ 2 =7.171, P <.05) and the MRI schedule of enhancement (χ 2 =11.244, P <.05) were significantly associated with the tumor regression patterns. Multivariate analysis showed molecular subtypes ( P <.05) and MRI pattern enhancement ( P <.05) were significant predictive factors. Molecular subtypes and the MRI enhancement patterns of the primary tumors were significant predictive factors for tumor regression patterns of breast cancer after NAC .

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