Imaging in Evaluation of Response to Neoadjuvant Breast Cancer Treatment Benefits of MRI

Balu–Maestro, C.; Chapellier, C.; Bleuse, A.; Chanalet, I.; Chauvel, C.; Largillier, R.

doi:10.1023/a:1014856713942

Cited by 176 publications

(98 citation statements)

References 29 publications

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“…Several studies have suggested that MRI is a more accurate method of delineating residual tumour following neoadjuvant chemotherapy than clinical, ultrasound or mammographic assessment (Boetes et al, 1995;Abraham et al, 1996;Drew et al, 1999Drew et al, , 2001Fischer et al, 1999;Balu-Maestro et al, 2002;Rieber et al, 2002;Cheung et al, 2003;Rosen et al, 2003;Martincich et al, 2004;Warren et al, 2004). Chemotherapy-induced fibrosis has been shown to impair the evaluation of tumour by conventional radiological methods and physical examination (Cocconi et al, 1984;Segel et al, 1988).…”

Section: Discussionmentioning

confidence: 99%

Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer

et al. 2008

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Contrast-enhanced magnetic resonance imaging (MRI) was used to monitor the response of patients undergoing neoadjuvant chemotherapy for breast cancer with the aim of undergoing breast-conserving surgery (BCS). Patients were prospectively recruited to undergo MRI as well as conventional methods of clinical examination, mammography (MM) and ultrasonography (USS) and response was assessed by each of these methods. Thirty-two patients with primary breast cancer were recruited. Magnetic resonance imaging correlation with histopathological size (r ¼ 0.71) was superior to USS (r ¼ 0.65) and to MM where tumour size was not measurable following chemotherapy in 71% of patients. Magnetic resonance imaging had 87.5% sensitivity (95% CI ¼ 68 -97%) and 50% specificity (95% CI ¼ 16 -84%) for a PPV (positive predictive value) of 99.8% and NPV (negative predictive value) of 80% for the detection of residual invasive cancer. Magnetic resonance imaging displayed 80% sensitivity (95% CI ¼ 28.4 -99.5%) and 89% specificity (95% CI ¼ 71 -98%) to detect pathological pCR in the breast. Eighty-four per cent of recruited patients were identified as potentially suitable candidates for BCS following chemotherapy and of those choosing to accept BCS, breast conservation was achieved in 90.5%, or 65.6% of all patients. Of those who proceeded to BCS, 9.5% required a re-do mastectomy because of positive margins; however, no residual tumour was found on histological examination of mastectomy specimens. Magnetic resonance imaging appears to be superior to conventional methods for assessing pathological response and the low rate of re-operation for positive margins indicates a valuable role in aiding the decision to undergo BCS or mastectomy.

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Section: Discussionmentioning

confidence: 99%

Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer

et al. 2008

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“…4,5 Magnetic resonance imaging (MRI) was reported to have results correlated better with pathology findings than mammography and obtained promising results when dynamic contrast agents are applied. [6][7][8] However, MRI is expensive and exogenous agents are needed for better contrast. In 1990s, diffuse optical tomography (DOT) has emerged with promises as an imaging tool for breast cancer screening and diagnosis because of its unique features such as non-ionizing radiation, low cost, and high intrinsic absorption contrast.…”

Section: Introductionmentioning

confidence: 99%

Diffuse optical tomography for breast cancer imaging guided by computed tomography: A feasibility study

Baikejiang

Zhang

2017

XST

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Abstract. Diffuse optical tomography (DOT) has attracted attentions in the last two decades due to its intrinsic sensitivity in imaging chromophores of tissues such as hemoglobin, water, and lipid. However, DOT has not been clinically accepted yet due to its low spatial resolution caused by strong optical scattering in tissues. Structural guidance provided by an anatomical imaging modality enhances the DOT imaging substantially. Here, we propose a computed tomography (CT) guided multispectral DOT imaging system for breast cancer imaging. To validate its feasibility, we have built a prototype DOT imaging system which consists of a laser at the wavelength of 650 nm and an electron multiplying charge coupled device (EMCCD) camera. We have validated the CT guided DOT reconstruction algorithms with numerical simulations and phantom experiments, in which different imaging setup parameters, such as projection number of measurements and width of measurement patch, have been investigated. Our results indicate that an air-cooling EMCCD camera is good enough for the transmission mode DOT imaging. We have also found that measurements at six angular projections are sufficient for DOT to reconstruct the optical targets with 2 and 4 times absorption contrast when the CT guidance is applied. Finally, we have described our future research plan on integration of a multispectral DOT imaging system into a breast CT scanner.

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“…23 With a sensitivity ranging from 63% to 100%, the MRI scan seems to be an accurate method of delineating residual tumor volume after neoadjuvant therapy for large breast tumors. [25][26][27][28][29] In our study, clinicopathologic sizes were well correlated with breast imaging, which was performed to rule out breast-preserving surgery. However, postchemotherapy mammograms could show extensive calcifications or stable disease whereas histopathologic results revealed breast-conserving surgery feasibility.…”

Section: Discussionmentioning

confidence: 76%

Breast‐conserving surgery after neoadjuvant anthracycline‐based chemotherapy for large breast tumors

Rouzier

Mathieu

Sidéris

et al. 2004

Cancer

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BACKGROUNDRandomized trials comparing neoadjuvant versus adjuvant chemotherapy show that primary chemotherapy allows more frequent breast‐preserving surgery even though no survival advantage has been demonstrated. The aim of the current study was to determine the predicting factors and the survival impact of breast conservation in patients with large breast tumors treated with neoadjuvant chemotherapy.METHODSBetween January 1987 and December 2001, 594 patients with invasive T2–3 breast carcinoma who were ineligible for breast‐conserving surgery (the mean initial tumor diameter was 49 mm) were treated with 3 or 4 courses of an anthracycline‐based primary chemotherapy, surgery, and radiotherapy. Various clinicopathologic factors were tested as possible predicting factors of breast‐preserving surgery. Survival analyses were performed to determine the implications of breast‐conserving surgery on outcome.RESULTSAfter primary chemotherapy, 287 (48%) patients were eligible for breast‐conserving surgery and 307 patients underwent a mastectomy. Initial tumor diameter > 5 cm, low histologic grade, lobular histology, and multicentricity were independent predicting factors of breast conservation ineligibility in the multivariate analysis (logistic regression). In the univariate survival analysis, a failure of breast‐preserving surgery was associated with a poor outcome. Local disease recurrence‐free survival rates were similar in patients treated with lumpectomy and mastectomy.CONCLUSIONSThe results reported in the current study suggested that initial diameter, histologic type and grade, and multicentricity are potential prechemotherapy predicting factors of breast conservation. When carefully selected, patients treated with breast conservation had a risk of local disease recurrence similar to the risk of chest wall disease recurrence after mastectomy. Cancer 2004. © 2004 American Cancer Society.

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Imaging in Evaluation of Response to Neoadjuvant Breast Cancer Treatment Benefits of MRI

Abstract: MRI appears to be a valuable technique for assessment of response to chemotherapy and identification of multifocal disease prior to surgery.

Cited by 176 publications

References 29 publications

Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer

Using MRI to plan breast-conserving surgery following neoadjuvant chemotherapy for early breast cancer

Diffuse optical tomography for breast cancer imaging guided by computed tomography: A feasibility study

Breast‐conserving surgery after neoadjuvant anthracycline‐based chemotherapy for large breast tumors

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