Survival is associated with complete response on MRI after neoadjuvant chemotherapy in ER-positive HER2-negative breast cancerReportar como inadecuado

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Breast Cancer Research

, 18:82

First Online: 05 August 2016Received: 02 December 2015Accepted: 25 July 2016DOI: 10.1186-s13058-016-0742-0

Cite this article as: Loo, C.E., Rigter, L.S., Pengel, K.E. et al. Breast Cancer Res 2016 18: 82. doi:10.1186-s13058-016-0742-0


BackgroundPathological complete remission pCR of estrogen receptor ER-positive-human epidermal growth factor receptor 2 HER2-negative breast cancer is rarely achieved after neoadjuvant chemotherapy NAC. In addition, the prognostic value of pCR for this breast cancer subtype is limited. We explored whether response evaluation by magnetic resonance imaging MRI is associated with recurrence-free survival after NAC in ER-positive-HER2-negative breast cancer.

MethodsMRI examinations were performed in 272 women with ER-positive-HER2-negative breast cancer before, during and after NAC. MRI interpretation included lesion morphology at baseline, changes in morphology and size, and contrast uptake kinetics. These MRI features, clinical characteristics and final pathology were correlated with recurrence-free survival.

ResultsThe median follow up time was 41 months. There were 35 women with events, including 19 breast-cancer-related deaths. On multivariable analysis, age younger than 50 years hazard ratio HR = 2.55, 95 % confidence interval CI 1.3, 5.02, p = 0.007, radiological complete response after NAC HR = 14.11, CI 1.81, 1818; p = 0.006 and smaller diameters of washout-plateau enhancement at MRI after NAC HR = 1.02, CI 1.00, 1.04, p = 0.036 were independently associated with best recurrence-free survival. Pathological response was not significant; HR = 2.12, CI 0.86, 4.64, p = 0.096.

ConclusionsMRI after NAC in ER-positive-HER2-negative tumors may be predictive of recurrence-free survival. A radiological complete response at MRI after NAC is associated with an excellent prognosis.

KeywordsBreast cancer Neoadjuvant chemotherapy Magnetic resonance imaging Recurrence-free survival Estrogen receptor  Download fulltext PDF

Autor: Claudette E. Loo - Lisanne S. Rigter - Kenneth E. Pengel - Jelle Wesseling - Sjoerd Rodenhuis - Marie-Jeanne T. F. D. 


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