title: Accuracy of MRI for estimating residual tumor size after neoadjuvant chemotherapy in locally advanced breast cancer: relation to response patterns on MRI.
abstract: BACKGROUND
  This study evaluated the accuracy of magnetic resonance imaging (MRI) for estimating residual tumor size after neoadjuvant chemotherapy in patients with locally advanced breast cancer and assessed whether the tumor pattern on MRI after chemotherapy influenced the accuracy of the MRI measurement of the residual tumor size.
  
  
  METHODS
  Fifty patients who received neoadjuvant chemotherapy with doxorubicin and docetaxel for locally advanced breast cancer were evaluated with MRI before and after chemotherapy. We compared the residual tumor size measured by MRI with the pathologically determined size and investigated the influence of the residual tumor pattern on MRI (shrinkage, nest or rim, and mixed) and pathologic characteristics on the accuracy of the MRI measurement.
  
  
  RESULTS
  The correlation coefficient between the residual tumor sizes determined by MRI and by pathology was 0.645. The MRI measurement agreed with the pathologically determined size in 36 patients (72%) and disagreed in 14 patients 928%), overestimating the size in 13 (26%) and underestimating the size in one (2%). disagreement appeared to be more frequent in the cases showing a nest or rim pattern than in those exhibiting a shrinkage pattern, although this was not statistically significant (p = 0.119).
  
  
  CONCLUSIONS
  MRI is an accurate method for predicting the extent of residual tumor after neoadjuvant chemotherapy; however, it may overestimate the residual disease, especially in cases showing a nest or rim tumor pattern and in those having combined lesions with ductal carcinoma in situ or multiple scattered nodules after neoadjuvant chemotherapy.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Young-Hyuck
authors.initials: YH
authors.lastname: Im
authors.forename: Boo-Kyung
authors.initials: BK
authors.lastname: Han
authors.forename: Nami
authors.initials: N
authors.lastname: Choi
authors.forename: Jeeyun
authors.initials: J
authors.lastname: Lee
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Yoon-La
authors.initials: YL
authors.lastname: Choi
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Ahn
authors.forename: Seok-Jin
authors.initials: SJ
authors.lastname: Nam
authors.forename: Young Suk
authors.initials: YS
authors.lastname: Park
authors.forename: Yeon Hyeon
authors.initials: YH
authors.lastname: Choe
authors.forename: Young-Hyeh
authors.initials: YH
authors.lastname: Ko
authors.forename: Jung-Hyun
authors.initials: JH
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D000077143:Docetaxel; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D011379:Prognosis; D015203:Reproducibility of Results; D043823:Taxoids / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D004317:Doxorubicin