Evaluation of MRI accuracy after primary systemic therapy in breast cancer patients considering tumor biology: optimizing the surgical planning

  • ALBERTO BOUZON Complexo Hospitalario Universitario A Coruña
  • Ángela Iglesias Complexo Hospitalario Universitario A Coruña
  • Benigno Acea Complexo Hospitalario Universitario A Coruña
  • Cristina Mosquera Complexo Hospitalario Universitario A Coruña
  • Paz Santiago Complexo Hospitalario Universitario A Coruña
  • Joaquín Mosquera Complexo Hospitalario Universitario A Coruña

Abstract

Background. We analyzed the accuracy of magnetic resonance imaging (MRI) after primary systemic therapy (PST) according to tumor subtype.

Methods. Two-hundred and four breast cancer patients treated with PST were studied. MRI findings after PST were compared with pathologic findings, and results were stratified based on tumor subtype.

Results. Of the two-hundred and four breast cancer patients, eighty-four (41.2%) achieved a pathologic complete response (pCR) in the breast. The MRI accuracy for predicting pCR was highest in triple-negative (TN) and HER2-positive (non-luminal) breast cancer (83.9 and 80.9%, respectively). The mean size discrepancy between MRI-measured and pathologic residual tumor size was lowest in TNBC and highest in luminal B-like (HER2-negative) breast cancer (0.45 cm vs. 0.98 cm, respectively; p=0.003). After breast conserving surgery (BCS), we found a lower rate of positive margins in TNBC and a higher rate of positive margins in luminal B-like (HER2-negative) breast cancer (2.4% vs. 23.6%, respectively).

Conclusions. If tumor response after PST is assessed by MRI, tumor subtype should be considered when BCS is planned. The accuracy of MRI is highest in TNBC.

Author Biographies

ALBERTO BOUZON, Complexo Hospitalario Universitario A Coruña

Department of Surgery

Breast Surgeon, MD, PhD

Ángela Iglesias, Complexo Hospitalario Universitario A Coruña
Department of Radiology

Breast Radiologist, MD
Benigno Acea, Complexo Hospitalario Universitario A Coruña

Department of Surgery

Breast Surgeon, MD, PhD

Cristina Mosquera, Complexo Hospitalario Universitario A Coruña

Department of Surgery

Surgeon, MD

Paz Santiago, Complexo Hospitalario Universitario A Coruña

Department of Pathology

Pathologist, MD

Joaquín Mosquera, Complexo Hospitalario Universitario A Coruña

Department of Radiology

Radiologist, MD

Published
2019-06-06
How to Cite
BOUZON, A., Iglesias, Ángela, Acea, B., Mosquera, C., Santiago, P., & Mosquera, J. (2019). Evaluation of MRI accuracy after primary systemic therapy in breast cancer patients considering tumor biology: optimizing the surgical planning. Radiology and Oncology, 53(2), 171-177. Retrieved from https://radioloncol.com/index.php/ro/article/view/3196
Section
Radiology