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[乳腺钼靶摄影、超声检查和磁共振成像在局部晚期乳腺癌新辅助化疗监测中的重要性]

[Importance of mammography, sonography and MRI for surveillance of neoadjuvant chemotherapy for locally advanced breast cancer].

作者信息

Schlossbauer T, Reiser M, Hellerhoff K

机构信息

Institut für Klinische Radiologe, Klinikum der Ludwig-Maximilians-Universität München, Campus Großhadern, Marchioninistr.15, 81377 München, Deutschland.

出版信息

Radiologe. 2010 Nov;50(11):1008-13. doi: 10.1007/s00117-010-2009-6.

Abstract

PURPOSE

The aim of this study is to give an overview on the surveillance of response to neoadjuvant chemotherapy in locally advanced breast cancer with mammography, ultrasound and breast MRI.

MATERIAL AND METHODS

The results of a recently presented study on surveillance in the course of chemotherapy with contrast-enhanced MRI are compared with ratings based on mammography and ultrasound.

RESULTS

Contrast-enhanced MRI correlates best with the histological tumor size when compared with mammography and ultrasound. Tumors with a high HER2 score (2+ with positive FISH test or 3+) show a significantly higher response compared to tumors with a lower HER2 score: size p <0.01, maximum enhancement p <0.01 and area under the curve (AUC) p <0.05. Reduction of tumor size and enhancement are complementary parameters and are not correlated to each other (r=0.22).

DISCUSSION

Contrast-enhanced MRI of the breast is a reliable method for quantification of the response to neoadjuvant chemotherapy. The reductions of tumor size and of tumor enhancement are not correlated. Therefore, it may be reasonable to take both aspects for quantification of therapy response into account. Further studies are needed for evaluation of the value of breast MRI as a prognostic factor.

摘要

目的

本研究旨在概述利用乳房X线摄影、超声和乳腺磁共振成像(MRI)对局部晚期乳腺癌新辅助化疗反应的监测情况。

材料与方法

将最近一项关于在化疗过程中使用对比增强MRI进行监测的研究结果与基于乳房X线摄影和超声的评级进行比较。

结果

与乳房X线摄影和超声相比,对比增强MRI与组织学肿瘤大小的相关性最佳。与HER2评分较低的肿瘤相比,HER2评分较高(FISH检测阳性的2+或3+)的肿瘤显示出明显更高的反应:大小p<0.01,最大强化p<0.01,曲线下面积(AUC)p<0.05。肿瘤大小的缩小和强化是互补参数,彼此不相关(r=0.22)。

讨论

乳腺对比增强MRI是量化新辅助化疗反应的可靠方法。肿瘤大小的缩小和肿瘤强化不相关。因此,将这两个方面都纳入治疗反应的量化考虑可能是合理的。需要进一步研究来评估乳腺MRI作为预后因素的价值。

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