title: Magnetic resonance imaging in breast cancer treated with neoadjuvant chemotherapy: radiologic-pathologic correlation of the response and disease-free survival depending on molecular subtype.
abstract: OBJECTIVE
  To evaluate the radiologic and pathologic responses to neoadjuvant chemotherapy and their correlation in the molecular subtypes of breast cancer and to analyze their impact in disease-free survival.
  
  
  METHODS
  We included 205 patients with breast cancer treated with neoadjuvant chemotherapy. We evaluated the radiologic response by comparing MRI images acquired before and after chemotherapy. The pathologic response was classified on the Miller and Payne scale. For each subtype (HER2+, TN, luminal A, luminal B HER2-, and luminal B HER2+), we used the χ(2) test, Student's t-test, ANOVA, and Kendall's Tau-b to evaluate the radiologic response and the pathologic response, the radiologic-pathologic correlation, and the disease-free survival.
  
  
  RESULTS
  The subtypes HER2+ (62.1%) and TN (45.2%) had higher rates of complete radiologic response. The pathologic response was 65.5% in the HER2+ subtype, 38.1% in the TN subtype, 2.6% in the luminal A subtype, 8.2% in the luminal B HER2- subtype, and 31% in the luminal B HER2+ subtype. The rate of radiologic-pathologic correlation was significant in all subtypes, higher in TN and HER2 (Tau-b coefficients 0.805 and 0.717, respectively). Disease-free survival was higher in HER2+ (91.9±3.3 months) and lower in TN (69.5±6.3 months), with significant differences between the cases with poor and good radiologic responses (P=.040). Survival was greater in cases with good radiologic response, except in cases with luminal A subtype.
  
  
  CONCLUSIONS
  MRI can be a useful tool that provides information about the evolution of breast cancer treated with neoadjuvant chemotherapy, which varies with the immunohistochemical subtype.
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España. Electronic address: silviacruzciria@gmail.com.
authors.forename: S
authors.initials: S
authors.lastname: Cruz Ciria
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: F
authors.initials: F
authors.lastname: Jiménez Aragón
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: C
authors.initials: C
authors.lastname: García Mur
authors.affiliation: Servicio de Radiodiagnóstico, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: H
authors.initials: H
authors.lastname: Esteban Cuesta
authors.affiliation: Servicio de Urgencias, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: B
authors.initials: B
authors.lastname: Gros Bañeres
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012189:Retrospective Studies
keywords: Breast cancer; Cáncer de mama; Imagen por resonancia magnética; Magnetic resonance imaging; Molecular subtypes; Neoadjuvant chemotherapy; Quimioterapia neoadyuvante; Radiologic response; Respuesta radiológica; Subtipos moleculares; Supervivencia; Survival