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Fig. 7 | Breast Cancer Research

Fig. 7

From: Contrast-enhanced spectral mammography in neoadjuvant chemotherapy monitoring: a comparison with breast magnetic resonance imaging

Fig. 7

Partial response correctly assessed with contrast-enhanced spectral mammography (CESM) but misinterpreted as a complete responder with MRI. Partial response to neoadjuvant chemotherapy (NAC) in a 48-year-old woman with a 97-mm invasive lobular carcinoma, luminal B, in the left breast, misinterpreted as a complete responder by MRI. Pre-NAC, evaluation showed wide non-focal enhancement on CESM (a medio-lateral oblique (MLO) recombined image) and on MRI (b axial maximum intensity projection (MIP) reconstruction). During-NAC, a concentric shrinkage and loss of enhancement intensity was visible on CESM (c MLO recombined image) and on MRI (d axial MIP reconstruction). Post-NAC, no pathological enhancement was visible on MRI (f axial MIP reconstruction), whereas in CESM (e MLO recombined image) faint enhancement in a part of the tumor bed (circle) was still visible, considered as residual tumor. The patient underwent mastectomy, and a partial response was confirmed by the histopathological examination of the surgical specimen, with 55 mm of residual invasive lobular carcinoma

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