title: Magnetic resonance imaging patterns of tumor regression in breast cancer patients after neo-adjuvant chemotherapy, and an analysis of the influencing factors.
abstract: The objective of this study was to analyze the patterns of breast tumor shrinkage in patients after neo-adjuvant chemotherapy (NAC) based on magnetic resonance imaging (MRI), and to evaluate the influential factors. Preoperative breast dynamic contrast-enhanced MRI was performed on 88 patients before NAC, every 2 weeks during their chemotherapy treatment, and the week before their surgery. The MRI enhancement pattern of the primary tumors was classified into one of four categories based on BI-RADS-MRI: type I (postcontrast mass image), II (multiple small masses image), III (postcontrast mass image with peripheral non-mass enhancement image), and IV (nonmass enhancement image). Multivariate regression and χ2test analyses were employed to establish significant associations. Two kinds of tumor regression patterns were observed: concentric shrinkage was observed in 39 lesions of 88 patients (44.3%), and nests or dendritic shrinkage was observed for the other 49 lesions (55.7%). ER+/HER2-, HER2+, and type I lesions were observed in 23 (62.2%), 21 (63.6%), and 29 (60.0%) patients, respectively, out of 49 nest or dendritic shrinkage pattern lesions. Triple negative breast cancer lesions, and type II, III, and IV lesions were observed in 13 (72.2%), 9 (81.8%), 10 (62.5%), and 10 (76.9%) patients, respectively, out of 39 lesions with a concentric shrinkage pattern. Molecular subtypes (χ2=7.171, P<.05) and the MRI schedule of enhancement (χ2=11.244, P<.05) were significantly associated with the tumor regression patterns. Multivariate analysis showed molecular subtypes (P<.05) and MRI pattern enhancement (P<.05) were significant predictive factors. Molecular subtypes and the MRI enhancement patterns of the primary tumors were significant predictive factors for tumor regression patterns of breast cancer after NAC.
authors.affiliation: The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: ManMan
authors.initials: M
authors.lastname: Li
authors.affiliation: The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Xu
authors.affiliation: The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Yingbo
authors.initials: Y
authors.lastname: Shao
authors.affiliation: The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.affiliation: The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: BingJie
authors.initials: B
authors.lastname: Du
authors.affiliation: The Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: JunHui
authors.initials: J
authors.lastname: Yuan
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests
chemical_list: D003287:Contrast Media
keywords: breast cancer; magnetic resonance imaging; molecular subtypes; neo-adjuvant chemotherapy; tumor regression