4.5 Article

Prediction of Pathologic Complete Response by Ultrasonography and Magnetic Resonance Imaging After Neoadjuvant Chemotherapy in Patients with Breast Cancer

期刊

CANCER MANAGEMENT AND RESEARCH
卷 12, 期 -, 页码 2603-2612

出版社

DOVE MEDICAL PRESS LTD
DOI: 10.2147/CMAR.S247279

关键词

breast neoplasms; neoadjuvant therapy; pathologic complete response; ultrasonography; magnetic resonance imaging

类别

资金

  1. National Natural Science Foundation of China [81627804, 81830058]

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Purpose: To compare the diagnostic performance for pathologic complete response (pCR) in breast cancer after neoadjuvant chemotherapy (NAC) between ultrasound (US) and magnetic resonance imaging (MRI). Patients and Methods: A total of 1,219 breast cancer patients with 1,232 tumors who accepted US and/or MRI examination after NAC and before breast surgery were included. The diagnostic performance of US, MRI, and US plus MRI in predicting pCR was compared. Results: The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of US for pCR were 36.2%, 90.2%, 71.0%, 67.3%, and 71.9%, respectively, while for MRI they were 44.4%, 92.9%, 75.6%, 77.7%, and 75.0%, respectively. The combination of US and MRI had increased specificity (98.0%) and PPV (86.8%), decreased sensitivity (22.5%) and NPV (68.8%), but similar accuracy (70.5%) in comparison with US or MRI alone. The prediction of pCR by imaging differed in different histological, molecular subtypes and primary tumor size. Conclusion: Neither US nor MRI could predict a pCR with sufficient accuracy. The combination of US and MRI could not predict a pCR reliably either. The explanation of imaging for pCR should take into account histological, molecular subtypes, and primary tumor size.

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