Breast Imaging and Breast Intervention Section, Shizuoka Cancer Center Hospital, Naga-izumi, Shizuoka, 411-8777, Japan.
Eur Radiol. 2010 Oct;20(10):2315-22. doi: 10.1007/s00330-010-1813-8. Epub 2010 May 9.
To retrospectively evaluate the magnetic resonance (MR) imaging findings of breast cancer before neoadjuvant chemotherapy (NAC) and to compare findings of chemosensitive breast cancer with those of chemoresistant breast cancer.
The MR imaging findings before NAC in 120 women undergoing NAC were reviewed. The MR imaging findings were compared with the pathological findings and responses.
A complete response (pCR) and marked response were achieved in 12 and 35% of 120 breast cancers in 120 women respectively. Breast cancers with a pCR or marked response were classified as chemosensitive breast cancer. The remaining 64 breast cancers (53%) were classified as chemoresistant breast cancer. Large tumour size, a lesion without mass effect, and very high intratumoural signal intensity on T2-weighted MR images were significantly associated with chemoresistant breast cancer. Lesions with mass effect and washout enhancement pattern were significantly associated with chemosensitive breast cancer. Areas with very high intratumoural signal intensity on T2-weighted images corresponded pathologically to areas of intratumoural necrosis.
Several MR imaging features of breast cancer before NAC can help predict the efficacy of NAC.
回顾分析乳腺癌新辅助化疗（NAC）前的磁共振成像（MR）表现，并比较化疗敏感型与化疗耐药型乳腺癌的 MR 表现。
对 120 例行 NAC 治疗的患者的 NAC 前 MR 成像表现进行回顾性分析。将 MR 成像表现与病理结果和治疗反应进行比较。
120 例乳腺癌患者中，12 例（12%）和 35 例（35%）患者的肿瘤完全缓解（pCR）和显著缓解。pCR 或显著缓解的乳腺癌被归类为化疗敏感型乳腺癌，其余 64 例（53%）乳腺癌为化疗耐药型乳腺癌。肿瘤较大、无肿块效应、T2 加权 MR 图像上肿瘤内信号强度极高与化疗耐药型乳腺癌显著相关，而具有肿块效应和流出增强模式的病变与化疗敏感型乳腺癌显著相关。T2 加权图像上肿瘤内信号强度极高的区域与肿瘤内坏死区域在病理上相对应。
NAC 前乳腺癌的几种 MR 成像特征有助于预测 NAC 的疗效。
