Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast Cancer
The heterogeneity of breast tumors might reflect biological complexity and provide prediction clues for the sensitivity of treatment. This study aimed to construct a model based on tumor heterogeneity in magnetic resonance imaging (MRI) for predicting the pathological complete response (pCR) to neoa...
Saved in:
| Main Authors: | , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-02-01
|
| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/32/2/93 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849719873962246144 |
|---|---|
| author | Mingxi Zhu Qiong Wu Xiaochuan Geng Huaying Xie Yan Wang Ziping Wu Yanping Lin Liheng Zhou Shuguang Xu Yumei Ye Wenjin Yin Jia Hua Jingsong Lu Yaohui Wang |
| author_facet | Mingxi Zhu Qiong Wu Xiaochuan Geng Huaying Xie Yan Wang Ziping Wu Yanping Lin Liheng Zhou Shuguang Xu Yumei Ye Wenjin Yin Jia Hua Jingsong Lu Yaohui Wang |
| author_sort | Mingxi Zhu |
| collection | DOAJ |
| description | The heterogeneity of breast tumors might reflect biological complexity and provide prediction clues for the sensitivity of treatment. This study aimed to construct a model based on tumor heterogeneity in magnetic resonance imaging (MRI) for predicting the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC). This retrospective study involved 217 patients with biopsy-confirmed invasive breast cancer who underwent MR before and after NAC. Patients were randomly divided into the training cohort and the validation cohort at a 1:1 ratio. MR images were processed by algorithms to quantify the heterogeneity of tumors. Models incorporating heterogeneity and clinical characteristics were constructed to predict pCR. The patterns of heterogeneity variation during NAC were classified into four categories abbreviated as the heterogeneity high-keep group (H_keep group), heterogeneity low-keep group (L_keep group), heterogeneity rising group, and decrease group. The average heterogeneity in patients achieving pCR was significantly lower than in those who did not (<i>p</i> = 0.029). Lower heterogeneity was independently associated with pCR (OR, 0.401 [95%CI: 0.21, 0.76]; <i>p</i> = 0.007). The model combining heterogeneity and clinical characteristics demonstrated improved specificity (True Negative Rate 0.857 vs. 0.698) and accuracy (Accuracy 0.828 vs. 0.753) compared to the clinical model. Survival outcomes were best for the L_keep group and worst for the rising group (Log-rank <i>p</i> = 0.031). Patients with increased heterogeneity exhibited a higher risk of recurrence approaching two years post-surgery, particularly within the non-pCR population. The quantified heterogeneity of breast cancer in MRI offers a non-invasive method for predicting pCR to NAC and evaluating the implementation of precision medicine. |
| format | Article |
| id | doaj-art-1b637a2335ce4ff9aca4a382bc2dd986 |
| institution | DOAJ |
| issn | 1198-0052 1718-7729 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj-art-1b637a2335ce4ff9aca4a382bc2dd9862025-08-20T03:12:02ZengMDPI AGCurrent Oncology1198-00521718-77292025-02-013229310.3390/curroncol32020093Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast CancerMingxi Zhu0Qiong Wu1Xiaochuan Geng2Huaying Xie3Yan Wang4Ziping Wu5Yanping Lin6Liheng Zhou7Shuguang Xu8Yumei Ye9Wenjin Yin10Jia Hua11Jingsong Lu12Yaohui Wang13Department of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Radiation Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Radiology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaDepartment of Breast Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, ChinaThe heterogeneity of breast tumors might reflect biological complexity and provide prediction clues for the sensitivity of treatment. This study aimed to construct a model based on tumor heterogeneity in magnetic resonance imaging (MRI) for predicting the pathological complete response (pCR) to neoadjuvant chemotherapy (NAC). This retrospective study involved 217 patients with biopsy-confirmed invasive breast cancer who underwent MR before and after NAC. Patients were randomly divided into the training cohort and the validation cohort at a 1:1 ratio. MR images were processed by algorithms to quantify the heterogeneity of tumors. Models incorporating heterogeneity and clinical characteristics were constructed to predict pCR. The patterns of heterogeneity variation during NAC were classified into four categories abbreviated as the heterogeneity high-keep group (H_keep group), heterogeneity low-keep group (L_keep group), heterogeneity rising group, and decrease group. The average heterogeneity in patients achieving pCR was significantly lower than in those who did not (<i>p</i> = 0.029). Lower heterogeneity was independently associated with pCR (OR, 0.401 [95%CI: 0.21, 0.76]; <i>p</i> = 0.007). The model combining heterogeneity and clinical characteristics demonstrated improved specificity (True Negative Rate 0.857 vs. 0.698) and accuracy (Accuracy 0.828 vs. 0.753) compared to the clinical model. Survival outcomes were best for the L_keep group and worst for the rising group (Log-rank <i>p</i> = 0.031). Patients with increased heterogeneity exhibited a higher risk of recurrence approaching two years post-surgery, particularly within the non-pCR population. The quantified heterogeneity of breast cancer in MRI offers a non-invasive method for predicting pCR to NAC and evaluating the implementation of precision medicine.https://www.mdpi.com/1718-7729/32/2/93breast neoplasmsmagnetic resonance imagingneoadjuvant chemotherapypathologic complete responserecurrence |
| spellingShingle | Mingxi Zhu Qiong Wu Xiaochuan Geng Huaying Xie Yan Wang Ziping Wu Yanping Lin Liheng Zhou Shuguang Xu Yumei Ye Wenjin Yin Jia Hua Jingsong Lu Yaohui Wang Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast Cancer Current Oncology breast neoplasms magnetic resonance imaging neoadjuvant chemotherapy pathologic complete response recurrence |
| title | Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast Cancer |
| title_full | Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast Cancer |
| title_fullStr | Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast Cancer |
| title_full_unstemmed | Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast Cancer |
| title_short | Measurement of Intratumor Heterogeneity and Its Changing Pattern to Predict Response and Recurrence Risk After Neoadjuvant Chemotherapy in Breast Cancer |
| title_sort | measurement of intratumor heterogeneity and its changing pattern to predict response and recurrence risk after neoadjuvant chemotherapy in breast cancer |
| topic | breast neoplasms magnetic resonance imaging neoadjuvant chemotherapy pathologic complete response recurrence |
| url | https://www.mdpi.com/1718-7729/32/2/93 |
| work_keys_str_mv | AT mingxizhu measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT qiongwu measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT xiaochuangeng measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT huayingxie measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT yanwang measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT zipingwu measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT yanpinglin measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT lihengzhou measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT shuguangxu measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT yumeiye measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT wenjinyin measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT jiahua measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT jingsonglu measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer AT yaohuiwang measurementofintratumorheterogeneityanditschangingpatterntopredictresponseandrecurrenceriskafterneoadjuvantchemotherapyinbreastcancer |