Drew P J, Kerin M J, Mahapatra T, Malone C, Monson J R, Turnbull L W, Fox J N
The University of Hull Academic Surgical Unit, Castle Hill Hospital, Castle Road, Hull HU16 5JQ, UK.
Eur J Surg Oncol. 2001 Nov;27(7):617-20. doi: 10.1053/ejso.2001.1194.
This study aimed to examine the feasibility of utilizing dynamic contrast-enhanced MRI (DCE-MRI) of the breast for the planning of surgical intervention following neoadjuvant therapy for locally advanced breast cancer (LABC).
Following their neoadjuvant therapy, women with LABC were followed-up by DCE-MRI in addition to clinical examination and mammography. If any modality suggested residual disease, surgery was carried out--initially salvage mastectomy and then breast-conserving surgery where appropriate.
Seventeen women were recruited: stage III (n=16), stage IV (n=1) mean age 55 (range 34-74). Following neoadjuvant therapy, 10 mastectomies and two local excisions were performed for 10 histologically confirmed residual cancers. Median follow-up for those women not undergoing surgery is 3.24 (IQR 2.8-3.5) years. DCE-MRI proved 100% accurate for the delineation of residual disease and facilitated the planning of the local excisions. Clinical examination and mammography proved inaccurate (PPV 83% and 75% and NPV 55% and 80%, respectively).
DCE-MRI is a potentially accurate method of delineating residual tumour following neoadjuvant therapy for LABC and may be used to plan appropriate operative intervention where required.
本研究旨在探讨利用乳腺动态对比增强磁共振成像（DCE-MRI）为局部晚期乳腺癌（LABC）新辅助治疗后的手术干预制定计划的可行性。
LABC女性患者在接受新辅助治疗后，除了进行临床检查和乳房X线摄影外，还接受了DCE-MRI随访。如果任何一种检查方式提示有残留病灶，则进行手术——最初是挽救性乳房切除术，然后在合适的情况下进行保乳手术。
招募了17名女性：III期（n = 16），IV期（n = 1），平均年龄55岁（范围34 - 74岁）。新辅助治疗后，对10例经组织学证实的残留癌患者进行了10次乳房切除术和2次局部切除术。未接受手术的患者的中位随访时间为3.24年（四分位间距2.8 - 3.5年）。DCE-MRI在描绘残留病灶方面的准确率为100%，并有助于局部切除术的规划。临床检查和乳房X线摄影被证明不准确（阳性预测值分别为83%和75%，阴性预测值分别为55%和80%）。
DCE-MRI是一种在LABC新辅助治疗后描绘残留肿瘤的潜在准确方法，可用于在需要时规划适当的手术干预。
