Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy

The objective of this study is to analyze magnetic resonance imaging shrinkage pattern of tumor regression after neoadjuvant chemotherapy and to evaluate its relationship with biological subtypes and pathological response. We reviewed the magnetic resonance imaging studies of 51 patients with single...

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Main Authors: Laura Ballesio, Silvia Gigli, Francesca Di Pastena, Guglielmo Giraldi, Lucia Manganaro, Emanuela Anastasi, Carlo Catalano
Format: Article
Language:English
Published: SAGE Publishing 2017-03-01
Series:Tumor Biology
Online Access:https://doi.org/10.1177/1010428317694540
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author Laura Ballesio
Silvia Gigli
Francesca Di Pastena
Guglielmo Giraldi
Lucia Manganaro
Emanuela Anastasi
Carlo Catalano
author_facet Laura Ballesio
Silvia Gigli
Francesca Di Pastena
Guglielmo Giraldi
Lucia Manganaro
Emanuela Anastasi
Carlo Catalano
author_sort Laura Ballesio
collection DOAJ
description The objective of this study is to analyze magnetic resonance imaging shrinkage pattern of tumor regression after neoadjuvant chemotherapy and to evaluate its relationship with biological subtypes and pathological response. We reviewed the magnetic resonance imaging studies of 51 patients with single mass-enhancing lesions (performed at time 0 and at the II and last cycles of neoadjuvant chemotherapy). Tumors were classified as Luminal A, Luminal B, HER2+, and Triple Negative based on biological and immunohistochemical analysis after core needle biopsy. We classified shrinkage pattern, based on tumor regression morphology on magnetic resonance imaging at the II cycle, as concentric, nodular, and mixed. We assigned a numeric score (0: none; 1: low; 2: medium; 3: high) to the enhancement intensity decrease. Pathological response on the surgical specimen was classified as complete (grade 5), partial (grades 4–3), and non-response (grades 1–2) according to Miller and Payne system. Fisher test was used to relate shrinkage pattern with biological subtypes and final pathological response. Seventeen patients achieved complete response, 25 partial response, and 9 non-response. A total of 13 lesions showed nodular pattern, 20 concentric, and 18 mixed. We found an association between concentric pattern and HER2+ (p < 0.001) and mixed pattern and Luminal A lesions (p < 0.001). We observed a statistical significant correlation between concentric pattern and complete response (p < 0.001) and between mixed pattern and non-response (p = 0.005). Enhancement intensity decrease 3 was associated with complete response (p < 0.001). Shrinkage pattern and enhancement intensity decrease may serve as early response indicators after neoadjuvant chemotherapy. Shrinkage pattern correlates with tumor biological subtypes.
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spelling doaj-art-08a941be80c84bd9bae0cbcd8a0675042025-08-20T03:16:03ZengSAGE PublishingTumor Biology1423-03802017-03-013910.1177/1010428317694540Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapyLaura Ballesio0Silvia Gigli1Francesca Di Pastena2Guglielmo Giraldi3Lucia Manganaro4Emanuela Anastasi5Carlo Catalano6Department of Radiological Oncological and Anatomopathological Sciences, Sapienza University of Rome and Umberto I Hospital, Rome, ItalyDepartment of Radiological Oncological and Anatomopathological Sciences, Sapienza University of Rome and Umberto I Hospital, Rome, ItalyDepartment of Radiological Oncological and Anatomopathological Sciences, Sapienza University of Rome and Umberto I Hospital, Rome, ItalyDepartment of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, ItalyDepartment of Radiological Oncological and Anatomopathological Sciences, Sapienza University of Rome and Umberto I Hospital, Rome, ItalyDepartment of Molecular Medicine, Sapienza University of Rome, Rome, ItalyDepartment of Radiological Oncological and Anatomopathological Sciences, Sapienza University of Rome and Umberto I Hospital, Rome, ItalyThe objective of this study is to analyze magnetic resonance imaging shrinkage pattern of tumor regression after neoadjuvant chemotherapy and to evaluate its relationship with biological subtypes and pathological response. We reviewed the magnetic resonance imaging studies of 51 patients with single mass-enhancing lesions (performed at time 0 and at the II and last cycles of neoadjuvant chemotherapy). Tumors were classified as Luminal A, Luminal B, HER2+, and Triple Negative based on biological and immunohistochemical analysis after core needle biopsy. We classified shrinkage pattern, based on tumor regression morphology on magnetic resonance imaging at the II cycle, as concentric, nodular, and mixed. We assigned a numeric score (0: none; 1: low; 2: medium; 3: high) to the enhancement intensity decrease. Pathological response on the surgical specimen was classified as complete (grade 5), partial (grades 4–3), and non-response (grades 1–2) according to Miller and Payne system. Fisher test was used to relate shrinkage pattern with biological subtypes and final pathological response. Seventeen patients achieved complete response, 25 partial response, and 9 non-response. A total of 13 lesions showed nodular pattern, 20 concentric, and 18 mixed. We found an association between concentric pattern and HER2+ (p < 0.001) and mixed pattern and Luminal A lesions (p < 0.001). We observed a statistical significant correlation between concentric pattern and complete response (p < 0.001) and between mixed pattern and non-response (p = 0.005). Enhancement intensity decrease 3 was associated with complete response (p < 0.001). Shrinkage pattern and enhancement intensity decrease may serve as early response indicators after neoadjuvant chemotherapy. Shrinkage pattern correlates with tumor biological subtypes.https://doi.org/10.1177/1010428317694540
spellingShingle Laura Ballesio
Silvia Gigli
Francesca Di Pastena
Guglielmo Giraldi
Lucia Manganaro
Emanuela Anastasi
Carlo Catalano
Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy
Tumor Biology
title Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy
title_full Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy
title_fullStr Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy
title_full_unstemmed Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy
title_short Magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer: Correlation with tumor biological subtypes and pathological response after therapy
title_sort magnetic resonance imaging tumor regression shrinkage patterns after neoadjuvant chemotherapy in patients with locally advanced breast cancer correlation with tumor biological subtypes and pathological response after therapy
url https://doi.org/10.1177/1010428317694540
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