title: Comparison of mammography, sonography, MRI and clinical examination in patients with locally advanced or inflammatory breast cancer who underwent neoadjuvant chemotherapy.
abstract: OBJECTIVE
  The purpose of this study was to determine the relative accuracies of mammography, sonography, MRI and clinical examination in predicting residual tumour size and pathological response after neoadjuvant chemotherapy for locally advanced or inflammatory breast cancer. Each prediction method was compared with the gold standard of surgical pathology.
  
  
  METHODS
  43 patients (age range, 25-62 years; mean age, 42.7 years) with locally advanced or inflammatory breast cancer who had been treated by neoadjuvant chemotherapy were enrolled prospectively. We compared the predicted residual tumour size and the predicted response on imaging and clinical examination with residual tumour size and response on pathology. Statistical analysis was performed using weighted kappa statistics and intraclass correlation coefficients (ICC).
  
  
  RESULTS
  The ICC values between predicted tumour size and pathologically determined tumour size were 0.65 for clinical examination, 0.69 for mammography, 0.78 for sonography and 0.97 for MRI. Agreement between the response predictions at mid-treatment and the responses measured by pathology had kappa values of 0.28 for clinical examination, 0.32 for mammography, 0.46 for sonography and 0.68 for MRI. Agreement between the final response predictions and the responses measured by pathology had kappa values of 0.43 for clinical examination, 0.44 for mammography, 0.50 for sonography and 0.82 for MRI.
  
  
  CONCLUSIONS
  Predictions of response and residual tumour size made on MRI were better correlated with the assessments of response and residual tumour size made upon pathology than were predictions made on the basis of clinical examination, mammography or sonography. Thus, the evaluation of predicted response using MRI could provide a relatively sensitive early assessment of chemotherapy efficacy.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan, College of Medicine, Songpa-Gu, Seoul, Korea
authors.forename: H J
authors.initials: HJ
authors.lastname: Shin
authors.forename: H H
authors.initials: HH
authors.lastname: Kim
authors.forename: J H
authors.initials: JH
authors.lastname: Ahn
authors.forename: S-B
authors.initials: SB
authors.lastname: Kim
authors.forename: K H
authors.initials: KH
authors.lastname: Jung
authors.forename: G
authors.initials: G
authors.lastname: Gong
authors.forename: B H
authors.initials: BH
authors.lastname: Son
authors.forename: S H
authors.initials: SH
authors.lastname: Ahn
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D058922:Inflammatory Breast Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D018365:Neoplasm, Residual; D010808:Physical Examination; D011446:Prospective Studies; D015203:Reproducibility of Results; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D000970:Antineoplastic Agents