title: Potential of reduction in total tumor volume measured with 3D-MRI as a prognostic factor for locally-advanced breast cancer patients treated with primary chemotherapy.
abstract: For accurate assessment of the response to primary chemotherapy (PCT) for locally advanced breast cancer, we measured reduction in total tumor volume (TTV) by using three-dimensional magnetic resonance imaging (3D MRI), and examined the relationship between this reduction and patient prognosis. Fifty-one patients with locally advanced breast cancer were treated with four cycles of docetaxel (60 mg/m(2)) before surgery. Tumor size was measured with calipers, ultrasonography (US) and conventional two-dimensional (2D) MRI before and after chemotherapy. TTV was measured with 3D MRI. These and other clinicopathological parameters were statistically analyzed to determine the prognosis for the patients. Median follow-up time was 46 months (1-64 months). Of the 51 patients, 25 developed distant recurrences. Patients whose TTV decreased by 75% or more after PCT showed significantly better prognosis than others, while tumor size measured with calipers, US and 2D MRI showed no significant relationship with patient prognosis. Of the clinicopathological parameters, only reduction in TTV and histological grade showed a significant association with distant recurrence-free survival (p = 0.03 and 0.02, log-rank test), while stepwise multivariate Cox's proportional hazards analysis identified TTV as the strongest independent prognostic factor. Reduction in TTV measured with 3D MRI can be a useful prognostic factor for patients with locally advanced breast cancer treated with PCT.
authors.affiliation: Department of Surgical Oncology, Osaka University, Osaka, Japan. anb45765@vesta.dti.ne.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Akazawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Tamaki
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Taguchi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tanji
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Miyoshi
authors.forename: Seung Jim
authors.initials: SJ
authors.lastname: Kim
authors.forename: Kenzo
authors.initials: K
authors.lastname: Shimazu
authors.forename: Satsuki
authors.initials: S
authors.lastname: Ueda
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yanagisawa
authors.forename: Noritsugu
authors.initials: N
authors.lastname: Okishiro
authors.forename: Mitsunobu
authors.initials: M
authors.lastname: Imazato
authors.forename: Kozuma
authors.initials: K
authors.lastname: Yasuyuki
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Sato
authors.forename: Shinichi
authors.initials: S
authors.lastname: Tamura
authors.forename: Shinzaburo
authors.initials: S
authors.lastname: Noguchi
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D000077143:Docetaxel; D005260:Female; D005784:Gene Amplification; D006801:Humans; D021621:Imaging, Three-Dimensional; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D015409:Mastectomy, Radical; D015412:Mastectomy, Segmental; D017698:Postmenopause; D017697:Premenopause; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D016019:Survival Analysis; D017741:Survivors; D043823:Taxoids / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D000077143:Docetaxel; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D043823:Taxoids