Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
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Prognostic Significance of a Complete Response on Breast MRI in Patients Who Received Neoadjuvant Chemotherapy According to the Molecular Subtype

  • Ko, Eun Sook (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Han, Heon (Department of Radiology, Kangwon National University Hospital) ;
  • Han, Boo-Kyung (Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Sun Mi (Department of Radiology, Seoul National University Bundang Hospital) ;
  • Kim, Rock Bum (Department of Preventive Medicine, Dong-A University School of Medicine) ;
  • Lee, Gyeong-Won (Division of Oncology-Hematology, Department of Internal Medicine, Gyeongsang National University School of Medicine) ;
  • Park, Yeon Hee (Division of Hematology/Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Nam, Seok Jin (Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine)
  • Received : 2014.10.15
  • Accepted : 2015.06.05
  • Published : 2015.09.01
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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.

Keywords

References

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