title: Evaluation of response to neoadjuvant chemoradiotherapy for locally advanced breast cancer with dynamic contrast-enhanced MRI of the breast.
abstract: OBJECTIVE
  This study aimed to examine the feasibility of utilizing dynamic contrast-enhanced MRI (DCE-MRI) of the breast for the planning of surgical intervention following neoadjuvant therapy for locally advanced breast cancer (LABC).
  
  
  METHODS
  Following their neoadjuvant therapy, women with LABC were followed-up by DCE-MRI in addition to clinical examination and mammography. If any modality suggested residual disease, surgery was carried out--initially salvage mastectomy and then breast-conserving surgery where appropriate.
  
  
  RESULTS
  Seventeen women were recruited: stage III (n=16), stage IV (n=1) mean age 55 (range 34-74). Following neoadjuvant therapy, 10 mastectomies and two local excisions were performed for 10 histologically confirmed residual cancers. Median follow-up for those women not undergoing surgery is 3.24 (IQR 2.8-3.5) years. DCE-MRI proved 100% accurate for the delineation of residual disease and facilitated the planning of the local excisions. Clinical examination and mammography proved inaccurate (PPV 83% and 75% and NPV 55% and 80%, respectively).
  
  
  CONCLUSIONS
  DCE-MRI is a potentially accurate method of delineating residual tumour following neoadjuvant therapy for LABC and may be used to plan appropriate operative intervention where required.
authors.affiliation: The University of Hull Academic Surgical Unit, Castle Hill Hospital, Castle Road, Hull HU16 5JQ, UK.
authors.forename: P J
authors.initials: PJ
authors.lastname: Drew
authors.forename: M J
authors.initials: MJ
authors.lastname: Kerin
authors.forename: T
authors.initials: T
authors.lastname: Mahapatra
authors.forename: C
authors.initials: C
authors.lastname: Malone
authors.forename: J R
authors.initials: JR
authors.lastname: Monson
authors.forename: L W
authors.initials: LW
authors.lastname: Turnbull
authors.forename: J N
authors.initials: JN
authors.lastname: Fox
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018365:Neoplasm, Residual; D018579:Patient Selection; D012680:Sensitivity and Specificity