Correlation of post-neoadjuvant chemotherapy response on MRI with final histology in breast cancer patients
© Mahatma et al. 2015
Published: 5 November 2015
We used MRI breasts to assess neoadjuvant chemotherapy response in line with departmental protocol. The aims were to see the correlation of findings on MRI with final histology in patients with breast cancer receiving neoadjuvant chemotherapy, and to assess the accuracy of our reporting and to evaluate the cause for any discordancy.
Retrospective data collection from March 2012 to May 2014. Data on 50 consecutive patients, who had both pre and post neoadjuvant MRIs, were collected. Use of CRIS, NBT PACS and UHB PACS for reports and image visualisation. Use of Ultra inquires on the intranet for histopathology reports.
Discrepancy in size of residual tumour between MRI and histology within 10 mm was considered concordant. Concordant size between MR and histology = 31/50 (62%). Discordant size between MR and histology = 19/50 (38%). For complete response: sensitivity = 46%, specificity = 86%, positive predictive value = 71% (95% CI 45−88%), negative predictive value = 70% (95% CI 53−82%), accuracy = 70%.
Good specificity but low sensitivity in line with published literature. The time interval between second MRI and time to surgery did not affect the ability of MRI to predict response. Presence of DCIS and LCIS (42%) influenced MRI-histology discrepancy. Hormonal-positive, Her2-positive and triple-positive were more likely to show size discrepancy compared with other hormone profiles.
We plan to integrate DWI into our reports to increase sensitivity.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.