Prognostic Significance of a Complete Response on Breast MRI in Patients Who Received Neoadjuvant Chemotherapy According to the Molecular Subtype
Korean Journal of Radiology
;
: 986-995, 2015.
Article
in English
| WPRIM
| ID: wpr-81039
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 ANDMETHODS:
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prognosis
/
Remission Induction
/
Breast Neoplasms
/
Magnetic Resonance Imaging
/
Receptors, Progesterone
/
Receptors, Estrogen
/
Proportional Hazards Models
/
Receptor, ErbB-2
/
Neoadjuvant Therapy
/
Kaplan-Meier Estimate
Type of study:
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
Language:
English
Journal:
Korean Journal of Radiology
Year:
2015
Type:
Article
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