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Erschienen in: Annals of Surgical Oncology 8/2011

01.08.2011 | Breast Oncology

Magnetic Resonance Imaging and Ultrasonography in Predicting Infiltrating Residual Disease after Preoperative Chemotherapy in Stage II–III Breast Cancer

verfasst von: Valentina Guarneri, MD, PhD, Annarita Pecchi, MD, Federico Piacentini, MD, Elena Barbieri, MD, Maria Vittoria Dieci, MD, Guido Ficarra, MD, Giovanni Tazzioli, MD, Antonio Frassoldati, MD, Rachele Battista, MD, Barbara Canossi, MD, Claudia Mauri, MD, Roberto D’Amico, MS, PierFranco Conte, MD, Pietro Torricelli, MD

Erschienen in: Annals of Surgical Oncology | Ausgabe 8/2011

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Abstract

Background

This study was designed to evaluate the accuracy of breast magnetic resonance imaging (MRI) and ultrasonography (US) in predicting the extent of breast residual disease after preoperative chemotherapy.

Methods

Patients with stage II–III invasive breast tumors who received preoperative chemotherapy and were imaged with post-treatment MRI were included. Histopathological verification was available for all patients. The longest diameter of residual tumor measured with MRI and US has been compared with the infiltrating residual tumor size at pathologic evaluation.

Results

A total of 108 patients were enrolled: 59 were imaged with both MRI and US (MRI group), and 49 were imaged with US only (non-MRI group). The non-MRI group was enrolled as an external control to avoid possible bias in the selection of patients. In the MRI group, the means of the deltas between MRI residual tumor size and pathologic size and between US and pathologic size were 0.16 cm and −0.06 cm respectively (P = not significant). Overall, a discrepancy limited in the interval from −0.5 cm to +0.5 cm compared with the pathologic size was observed in 54% and 51% of the patients with MRI and US, respectively (P = not significant). The linear correlation between the radiological measurement and pathologic tumor size was r = 0.53 for MRI and r = 0.66 for breast US. In the non-MRI group, the mean of the deltas between US residual tumor size and pathologic size was 0.06 cm, and the linear correlation was r = 0.79.

Conclusions

In this series of patients, MRI and US do not show significant differences in predicting the breast residual infiltrating tumor after preoperative chemotherapy.
Literatur
1.
Zurück zum Zitat Bonadonna G, Veronesi U, Brambilla C, et al. Primary chemotherapy to avoid mastectomy in tumors with diameters of three centimeters or more. J Natl Cancer Inst. 1990;82:1539–45.PubMedCrossRef Bonadonna G, Veronesi U, Brambilla C, et al. Primary chemotherapy to avoid mastectomy in tumors with diameters of three centimeters or more. J Natl Cancer Inst. 1990;82:1539–45.PubMedCrossRef
2.
Zurück zum Zitat Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol. 1997;15:2483–93.PubMed Fisher B, Brown A, Mamounas E, et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18. J Clin Oncol. 1997;15:2483–93.PubMed
3.
Zurück zum Zitat Mauri D, Pavlidis N, Ioannidis JP. Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis. J Natl Cancer Inst. 2005;97:188–94.PubMedCrossRef Mauri D, Pavlidis N, Ioannidis JP. Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis. J Natl Cancer Inst. 2005;97:188–94.PubMedCrossRef
4.
Zurück zum Zitat Hieken TJ, Harrison J, Herreros J, Velasco JM. Correlating sonography, mammography, and pathology in the assessment of breast cancer size. Am J Surg. 2001;182:351–4.PubMedCrossRef Hieken TJ, Harrison J, Herreros J, Velasco JM. Correlating sonography, mammography, and pathology in the assessment of breast cancer size. Am J Surg. 2001;182:351–4.PubMedCrossRef
5.
Zurück zum Zitat Bosch AM, Kessels AG, Beets GL, Rupa JD, Koster D, van Engelshoven JM, von Meyenfeldt MF. Preoperative estimation of the pathological breast tumour size by physical examination, mammography and ultrasound: a prospective study on 105 invasive tumours. Eur J Radiol. 2003;48:285–92.PubMedCrossRef Bosch AM, Kessels AG, Beets GL, Rupa JD, Koster D, van Engelshoven JM, von Meyenfeldt MF. Preoperative estimation of the pathological breast tumour size by physical examination, mammography and ultrasound: a prospective study on 105 invasive tumours. Eur J Radiol. 2003;48:285–92.PubMedCrossRef
6.
Zurück zum Zitat Golshan M, Fung BB, Wiley E, Wolfman J, Rademaker A, Morrow M. Prediction of breast cancer size by ultrasound, mammography and core biopsy. Breast. 2004;13:265–71.PubMedCrossRef Golshan M, Fung BB, Wiley E, Wolfman J, Rademaker A, Morrow M. Prediction of breast cancer size by ultrasound, mammography and core biopsy. Breast. 2004;13:265–71.PubMedCrossRef
7.
Zurück zum Zitat Grimsby GM, Gray R, Dueck A, et al. Is there concordance of invasive breast cancer pathologic tumor size with magnetic resonance imaging? Am J Surg. 2009;198:500–4.PubMedCrossRef Grimsby GM, Gray R, Dueck A, et al. Is there concordance of invasive breast cancer pathologic tumor size with magnetic resonance imaging? Am J Surg. 2009;198:500–4.PubMedCrossRef
8.
Zurück zum Zitat Esserman L, Hylton N, Yassa L, Barclay J, Frankel S, Sickles E. Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging. J Clin Oncol. 1999;17:110–9.PubMed Esserman L, Hylton N, Yassa L, Barclay J, Frankel S, Sickles E. Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging. J Clin Oncol. 1999;17:110–9.PubMed
9.
Zurück zum Zitat Belli P, Costantini M, Malaspina C, Magistrelli A, Latorre G, Bonomo L. MRI accuracy in residual disease evaluation in breast cancer patients treated with neoadjuvant chemotherapy. Clin Radiol. 2006;61:946–53.PubMedCrossRef Belli P, Costantini M, Malaspina C, Magistrelli A, Latorre G, Bonomo L. MRI accuracy in residual disease evaluation in breast cancer patients treated with neoadjuvant chemotherapy. Clin Radiol. 2006;61:946–53.PubMedCrossRef
10.
Zurück zum Zitat Partridge SC, Gibbs JE, Lu Y, Esserman LJ, Sudilovsky D, Hylton NM. Accuracy of MR imaging for revealing residual breast cancer in patients who have undergone neoadjuvant chemotherapy. AJR Am J Roentgenol. 2002;179:1193–9.PubMed Partridge SC, Gibbs JE, Lu Y, Esserman LJ, Sudilovsky D, Hylton NM. Accuracy of MR imaging for revealing residual breast cancer in patients who have undergone neoadjuvant chemotherapy. AJR Am J Roentgenol. 2002;179:1193–9.PubMed
11.
Zurück zum Zitat Wasser K, Sinn HP, Fink, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy. Eur Radiol. 2003;13:1213–23.PubMed Wasser K, Sinn HP, Fink, et al. Accuracy of tumor size measurement in breast cancer using MRI is influenced by histological regression induced by neoadjuvant chemotherapy. Eur Radiol. 2003;13:1213–23.PubMed
12.
Zurück zum Zitat Yeh E, Slanetz P, Kopans DB, et al. Prospective comparison of mammography, sonography, and MRI in patients undergoing neoadjuvant chemotherapy for palpable breast cancer. AJR Am J Roentgenol. 2005;184:868–77.PubMed Yeh E, Slanetz P, Kopans DB, et al. Prospective comparison of mammography, sonography, and MRI in patients undergoing neoadjuvant chemotherapy for palpable breast cancer. AJR Am J Roentgenol. 2005;184:868–77.PubMed
13.
Zurück zum Zitat Balu-Maestro C, Chapellier C, Bleuse A, Chanalet I, Chauvel C, Largillier R. Imaging in evaluation of response to neoadjuvant breast cancer treatment benefits of MRI. Breast Cancer Res Treat. 2002;72:145–52.PubMedCrossRef Balu-Maestro C, Chapellier C, Bleuse A, Chanalet I, Chauvel C, Largillier R. Imaging in evaluation of response to neoadjuvant breast cancer treatment benefits of MRI. Breast Cancer Res Treat. 2002;72:145–52.PubMedCrossRef
14.
Zurück zum Zitat Weatherall PT, Evans GF, Metzger GJ, Saborrian MH, Leitch AM. MRI vs. histologic measurement of breast cancer following chemotherapy: comparison with x-ray mammography and palpation. J Magn Reson Imaging. 2001;13:868–75.PubMedCrossRef Weatherall PT, Evans GF, Metzger GJ, Saborrian MH, Leitch AM. MRI vs. histologic measurement of breast cancer following chemotherapy: comparison with x-ray mammography and palpation. J Magn Reson Imaging. 2001;13:868–75.PubMedCrossRef
15.
Zurück zum Zitat Segara D, Krop IE, Garber JE, et al. Does MRI predict pathologic tumor response in women with breast cancer undergoing preoperative chemotherapy? J Surg Oncol. 2007;96:474–80.PubMedCrossRef Segara D, Krop IE, Garber JE, et al. Does MRI predict pathologic tumor response in women with breast cancer undergoing preoperative chemotherapy? J Surg Oncol. 2007;96:474–80.PubMedCrossRef
16.
Zurück zum Zitat Denis F, Desbiez-Bourcier AV, Chapiron C, Arbion F, Body G, Brunereau L. Contrast enhanced magnetic resonance imaging underestimates residual disease following neoadjuvant docetaxel based chemotherapy for breast cancer. Eur J Surg Oncol. 2004;30:1069–76.PubMedCrossRef Denis F, Desbiez-Bourcier AV, Chapiron C, Arbion F, Body G, Brunereau L. Contrast enhanced magnetic resonance imaging underestimates residual disease following neoadjuvant docetaxel based chemotherapy for breast cancer. Eur J Surg Oncol. 2004;30:1069–76.PubMedCrossRef
17.
Zurück zum Zitat Chen JH, Feig B, Agrawal G, et al. MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy. Cancer. 2008;112:17–26.PubMedCrossRef Chen JH, Feig B, Agrawal G, et al. MRI evaluation of pathologically complete response and residual tumors in breast cancer after neoadjuvant chemotherapy. Cancer. 2008;112:17–26.PubMedCrossRef
18.
Zurück zum Zitat Schott AF, Roubidoux MA, Helvie MA, et al. Clinical and radiologic assessments to predict breast cancer pathologic complete response to neoadjuvant chemotherapy. Breast Cancer Res Treat. 2005;92:231–8.PubMedCrossRef Schott AF, Roubidoux MA, Helvie MA, et al. Clinical and radiologic assessments to predict breast cancer pathologic complete response to neoadjuvant chemotherapy. Breast Cancer Res Treat. 2005;92:231–8.PubMedCrossRef
19.
Zurück zum Zitat Rieber A, Brambs HJ, Gabelmann A, Heilmann V, Kreienberg R, Kühn T. Breast MRI for monitoring response of primary breast cancer to neo-adjuvant chemotherapy. Eur Radiol. 2002;12:1711–9.PubMedCrossRef Rieber A, Brambs HJ, Gabelmann A, Heilmann V, Kreienberg R, Kühn T. Breast MRI for monitoring response of primary breast cancer to neo-adjuvant chemotherapy. Eur Radiol. 2002;12:1711–9.PubMedCrossRef
20.
Zurück zum Zitat Kwong MS, Chung GG, Horwath LJ, et al. Postchemotherapy MRI overestimates residual disease compared with histopathology in responders to neoadjuvant therapy for locally advanced breast cancer. Cancer J. 2006;12:212–21.PubMedCrossRef Kwong MS, Chung GG, Horwath LJ, et al. Postchemotherapy MRI overestimates residual disease compared with histopathology in responders to neoadjuvant therapy for locally advanced breast cancer. Cancer J. 2006;12:212–21.PubMedCrossRef
21.
Zurück zum Zitat Orel S. Who should have breast magnetic resonance imaging evaluation? Clin Oncol. 2008;26:703–11.CrossRef Orel S. Who should have breast magnetic resonance imaging evaluation? Clin Oncol. 2008;26:703–11.CrossRef
22.
Zurück zum Zitat Houssami N, Ciatto S, Macaskill P, Lord SJ, Warren RM, Dixon JM, Irwig L. Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer. J Clin Oncol. 2008;26:3248–58.PubMedCrossRef Houssami N, Ciatto S, Macaskill P, Lord SJ, Warren RM, Dixon JM, Irwig L. Accuracy and surgical impact of magnetic resonance imaging in breast cancer staging: systematic review and meta-analysis in detection of multifocal and multicentric cancer. J Clin Oncol. 2008;26:3248–58.PubMedCrossRef
23.
Zurück zum Zitat Sardanelli F, Boetes C, Borisch B, et al. Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer. 2010;46:1296–316.PubMedCrossRef Sardanelli F, Boetes C, Borisch B, et al. Magnetic resonance imaging of the breast: recommendations from the EUSOMA working group. Eur J Cancer. 2010;46:1296–316.PubMedCrossRef
24.
Zurück zum Zitat Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy. AJR Am J Roentgenol. 2003;181:1275–82.PubMed Rosen EL, Blackwell KL, Baker JA, et al. Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy. AJR Am J Roentgenol. 2003;181:1275–82.PubMed
25.
Zurück zum Zitat Cheung YC, Chen SC, Su MY, et al. Monitoring the size and response of locally advanced breast cancers to neoadjuvant chemotherapy (weekly paclitaxel and epirubicin) with serial enhanced MRI. Breast Cancer Res Treat. 2003;78:51–8.PubMedCrossRef Cheung YC, Chen SC, Su MY, et al. Monitoring the size and response of locally advanced breast cancers to neoadjuvant chemotherapy (weekly paclitaxel and epirubicin) with serial enhanced MRI. Breast Cancer Res Treat. 2003;78:51–8.PubMedCrossRef
26.
Zurück zum Zitat Kim HJ, Im YH, Han BK, et al. Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in locally advanced breast cancer: relation to response patterns on MRI. Acta Oncol. 2007;46:996–1003.PubMedCrossRef Kim HJ, Im YH, Han BK, et al. Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in locally advanced breast cancer: relation to response patterns on MRI. Acta Oncol. 2007;46:996–1003.PubMedCrossRef
27.
Zurück zum Zitat Chen JH, Mehta RS, Carpenter PM, Nalcioglu O, Su MY. Magnetic resonance imaging in predicting pathological response of triple negative breast cancer following neoadjuvant chemotherapy. J Clin Oncol. 2007;25:5667–9.PubMedCrossRef Chen JH, Mehta RS, Carpenter PM, Nalcioglu O, Su MY. Magnetic resonance imaging in predicting pathological response of triple negative breast cancer following neoadjuvant chemotherapy. J Clin Oncol. 2007;25:5667–9.PubMedCrossRef
28.
Zurück zum Zitat Moon HG, Han W, Lee JW, et al. Age and HER2 expression status affect MRI accuracy in predicting residual tumor extent after neo-adjuvant systemic treatment. Ann Oncol. 2009;20:636–41.PubMedCrossRef Moon HG, Han W, Lee JW, et al. Age and HER2 expression status affect MRI accuracy in predicting residual tumor extent after neo-adjuvant systemic treatment. Ann Oncol. 2009;20:636–41.PubMedCrossRef
29.
Zurück zum Zitat Bahri S, Chen JH, Mehta RS, et al. Residual breast cancer diagnosed by MRI in patients receiving neoadjuvant chemotherapy with and without bevacizumab. Ann Surg Oncol. 2009;16:1619–28.PubMedCrossRef Bahri S, Chen JH, Mehta RS, et al. Residual breast cancer diagnosed by MRI in patients receiving neoadjuvant chemotherapy with and without bevacizumab. Ann Surg Oncol. 2009;16:1619–28.PubMedCrossRef
30.
Zurück zum Zitat Turnbull L, Brown S, Harvey I, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomized controlled trial. Lancet. 2010;375:563–71.PubMedCrossRef Turnbull L, Brown S, Harvey I, et al. Comparative effectiveness of MRI in breast cancer (COMICE) trial: a randomized controlled trial. Lancet. 2010;375:563–71.PubMedCrossRef
Metadaten
Titel
Magnetic Resonance Imaging and Ultrasonography in Predicting Infiltrating Residual Disease after Preoperative Chemotherapy in Stage II–III Breast Cancer
verfasst von
Valentina Guarneri, MD, PhD
Annarita Pecchi, MD
Federico Piacentini, MD
Elena Barbieri, MD
Maria Vittoria Dieci, MD
Guido Ficarra, MD
Giovanni Tazzioli, MD
Antonio Frassoldati, MD
Rachele Battista, MD
Barbara Canossi, MD
Claudia Mauri, MD
Roberto D’Amico, MS
PierFranco Conte, MD
Pietro Torricelli, MD
Publikationsdatum
01.08.2011
Verlag
Springer-Verlag
Erschienen in
Annals of Surgical Oncology / Ausgabe 8/2011
Print ISSN: 1068-9265
Elektronische ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1590-x

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