title: Role of dynamic magnetic resonance imaging in the evaluation of tumor response to preoperative concurrent radiochemotherapy for large breast cancers: a prospective phase II study.
abstract: OBJECTIVE
  To evaluate the accuracy of clinical examination and of three imaging modalities (ultrasound [US] scan, mammography, and magnetic resonance imaging [MRI]) to assess the tumor response of breast cancer to a preoperative regimen of concurrent radiochemotherapy for large breast cancers, using pathologic data as the reference.
  
  
  METHODS
  Sixty women were accrued. Treatment consisted of 4 cycles of (5-fluorouracil-vinorelbine) chemotherapy with, starting with the second cycle of chemotherapy, locoregional radiotherapy to the breast and the internal mammary and supraclavicular and infraclavicular lymph nodes. Breast surgery and axillary lymph node dissection were subsequently performed. Breast imaging assessments were performed both before chemotherapy and preoperatively.
  
  
  RESULTS
  The correlation coefficients between tumor dimension at imaging and pathology were statistically significant for US scan (r = 0.4; p = 0.006) and MRI (r = 0.4; p = 0.004) but not for clinical examination (r = 0.2; p = 0.16) or mammography (r = -0.15; p = 0.31). Furthermore, the area under the receiver operating characteristic curve for MRI was 0.81, compared with 0.67 for US scan. At the optimal threshold score, MRI performed with 81% sensitivity and 75% specificity.
  
  
  CONCLUSIONS
  Compared with clinical examination, US scan, or mammography, MRI substantially improved the prediction of pathologic tumor response to preoperative concurrent radiochemotherapy for large breast cancers.
authors: Department of Radiation Oncology, Institut Curie, Paris, France. marc.bollet@curie.net
authors: Marc A
authors: MA
authors: Bollet
authors: Fabienne
authors: F
authors: Thibault
authors: Kim
authors: K
authors: Bouillon
authors: Martine
authors: M
authors: Meunier
authors: Brigitte
authors: B
authors: Sigal-Zafrani
authors: Alexia
authors: A
authors: Savignoni
authors: Véronique
authors: V
authors: Diéras
authors: Claude
authors: C
authors: Nos
authors: Rémy
authors: R
authors: Salmon
authors: Alain
authors: A
authors: Fourquet
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D018275:Carcinoma, Lobular / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy / Q000379:methods; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008327:Mammography; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012075:Remission, Spontaneous; D016896:Treatment Outcome; D016217:Ultrasonography, Mammary
chemical_list: D003287:Contrast Media