title: Variation of breast vascular maps on dynamic contrast-enhanced MRI after primary chemotherapy of locally advanced breast cancer.
abstract: OBJECTIVE
  The purpose of this article is to assess changes in breast vascular maps on dynamic contrast-enhanced MRI (DCE-MRI) after primary chemotherapy in patients with locally advanced breast cancer (LABC).
  
  
  METHODS
  Thirty-four patients with unilateral LABC underwent DCE-MRI before and after anthracycline- and taxane-based primary chemotherapy. The number of vessels 30 mm or longer in length and 2 mm or larger in maximum transverse diameter were counted on maximum intensity projections of the first subtracted phase for each of the two breasts. Patients achieving pathologic response or small clusters of residual cancer cells after primary chemotherapy were considered as responders, and those with an inferior pathologic response were considered as nonresponders.
  
  
  RESULTS
  The mean (± SD) number of vessels in the breast harboring the cancer and in the contralateral breast was 2.7 ± 1.3 and 1.1 ± 1.0 (p < 0.001), respectively, before primary chemotherapy and 1.3 ± 1.1 and 1.1 ± 1.1 (p = 0.147), respectively, after primary chemotherapy. Overall, primary chemotherapy was associated with a significant reduction in DCE-MRI vascular maps in the breast harboring the cancer only (p < 0.001). Of the 34 patients, 10 were considered responders and 24 were nonresponders. The mean number of vessels in the breast harboring the cancer changed from 2.7 ± 1.1 to 0.6 ± 0.8 for the 10 responders and from 2.7 ± 1.4 to only 1.6 ± 0.9 for the 24 nonresponders. The mean reduction of vascular map in the breast harboring the cancer was significantly higher in responders compared with nonresponders (p = 0.017).
  
  
  CONCLUSIONS
  Before primary chemotherapy, DCE-MRI vascular maps were asymmetrically increased ipsilaterally to the LABC. After primary chemotherapy, vascular maps significantly changed only in the breast harboring the cancer, with significant differences between responders and nonresponders.
authors.affiliation: Unit of Diagnostic Imaging, Institute for Cancer Research and Treatment, Candiolo, Turin, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Martincich
authors.forename: Ilaria
authors.initials: I
authors.lastname: Bertotto
authors.forename: Filippo
authors.initials: F
authors.lastname: Montemurro
authors.forename: Riccardo
authors.initials: R
authors.lastname: Ponzone
authors.forename: Luca A
authors.initials: LA
authors.lastname: Carbonaro
authors.forename: Daniele
authors.initials: D
authors.lastname: Regge
authors.forename: Francesco
authors.initials: F
authors.lastname: Sardanelli
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000098:blood supply* / Q000188:drug therapy* / Q000473:pathology; D002277:Carcinoma / Q000098:blood supply* / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D003287:Contrast Media; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use; D011237:Predictive Value of Tests; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D003287:Contrast Media; D004317:Doxorubicin; D019786:Gadolinium DTPA; D017239:Paclitaxel