Prognostic Significance of a Complete Response on Breast MRI in Patients Who Received Neoadjuvant Chemotherapy According to the Molecular Subtype.
10.3348/kjr.2015.16.5.986
- Author:
Eun Sook KO
1
;
Heon HAN
;
Boo Kyung HAN
;
Sun Mi KIM
;
Rock Bum KIM
;
Gyeong Won LEE
;
Yeon Hee PARK
;
Seok Jin NAM
Author Information
1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea.
- Publication Type:Original Article
- Keywords:
Breast cancer;
Magnetic resonance imaging;
Neoadjuvant chemotherapy;
Prognosis;
Subtype
- MeSH:
Adult;
Aged;
Antineoplastic Agents/therapeutic use;
Breast Neoplasms/drug therapy/mortality/*pathology;
Female;
Humans;
Kaplan-Meier Estimate;
*Magnetic Resonance Imaging;
Middle Aged;
Neoadjuvant Therapy;
Neoplasm Recurrence, Local;
Prognosis;
Proportional Hazards Models;
Receptor, ErbB-2/genetics/metabolism;
Receptors, Estrogen/genetics/metabolism;
Receptors, Progesterone/genetics/metabolism;
Remission Induction
- From:Korean Journal of Radiology
2015;16(5):986-995
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To evaluate the relationship between response categories assessed by magnetic resonance imaging (MRI) or pathology and survival outcomes, and to determine whether there are prognostic differences among molecular subtypes. MATERIALS AND METHODS: We evaluated 174 patients with biopsy-confirmed invasive breast cancer who had undergone MRI before and after neoadjuvant chemotherapy, but before surgery. Pathology findings were classified as a pathologic complete response (pCR) or a non-pCR, and MRI findings were designated as a radiologic CR (rCR) or a non-rCR. We evaluated overall and subtype-specific associations between clinicopathological factors including the assessment categories and recurrence, using the Cox proportional hazards model. RESULTS: There were 41 recurrences (9 locoregional and 32 distant recurrences). There were statistically significant differences in recurrence outcomes between patients who achieved a radiologic or a pCR and patients who did not achieve a radiologic or a pCR (recurrence hazard ratio, 11.02; p = 0.018 and recurrence hazard ratio, 3.93; p = 0.022, respectively). Kaplan-Meier curves for recurrence-free survival showed that triple-negative breast cancer was the only subtype that showed significantly better outcomes in patients who achieved a CR compared to patients who did not achieve a CR by both radiologic and pathologic assessments (p = 0.004 and 0.001, respectively). A multivariate analysis found that patients who achieved a rCR and a pCR did not display significantly different recurrence outcomes (recurrence hazard ratio, 2.02; p = 0.505 and recurrence hazard ratio, 1.12; p = 0.869, respectively). CONCLUSION: Outcomes of patients who achieved a rCR were similar to those of patients who achieved a pCR. To evaluate survival difference according to molecular subtypes, a larger study is needed.
