title: Magnetic resonance imaging shrinkage patterns following neoadjuvant chemotherapy for breast carcinomas with an emphasis on the radiopathological correlations.
abstract: Preoperative neoadjuvant chemotherapy (NAC) is considered to be the standard treatment for locally-advanced breast carcinomas. Obtaining precise information regarding the tumor extent and distribution by imaging modalities to assess the success of breast-conserving surgery following NAC is extremely important. Analysis of the detailed radiopathological correlation of magnetic resonance imaging (MRI) following NAC has not been reported previously. The MRI and histopathological shrinkage patterns of residual breast carcinomas in 27 consecutive cases were analyzed following NAC and classified into five categories: Types I and II (concentric shrinkage with and without surrounding lesions, respectively); type III (shrinkage with residual multinodular lesions); type IV (diffuse contrast enhancement in whole quadrant); and non-visualization. The present study clearly demonstrated that the most common MRI shrinkage pattern was type I (11 cases), followed by type II and non-visualization, and the most common histopathological shrinkage pattern was type II (11 cases), followed by type III (8 cases). The concordance rate between MRI and pathological patterns was 48% and the worst concordance MRI pattern was type I. MRI is considered to be a useful method for evaluation of the residual carcinoma following NAC. However, the concordance rate was low in the MRI pattern I cases and tiny foci of residual carcinoma were present in half of the non-visualization cases, as shown by MRI. Therefore, the tumor extent must be completely resected for patients who undergo NAC, and postoperative radiation may be important for preventing local recurrence of breast carcinoma.
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Kaori
authors: K
authors: Tomida
authors: Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Mitsuaki
authors: M
authors: Ishida
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Tomoko
authors: T
authors: Umeda
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Sachiko
authors: S
authors: Sakai
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Yuki
authors: Y
authors: Kawai
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Tsuyoshi
authors: T
authors: Mori
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Yoshihiro
authors: Y
authors: Kubota
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Eiji
authors: E
authors: Mekata
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Shigeyuki
authors: S
authors: Naka
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Hajime
authors: H
authors: Abe
authors: Clinical Laboratory Medicine and Division of Diagnostic Pathology, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Hidetoshi
authors: H
authors: Okabe
authors: Departments of Surgery, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan.
authors: Tohru
authors: T
authors: Tani
keywords: breast cancer; magnetic resonance imaging; neoadjuvant chemotherapy; shrinkage pattern