Department of Quantum Medical Technology, Graduate School of Medical Science, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, 920-0942 Japan.
Acad Radiol. 2011 Aug;18(8):963-9. doi: 10.1016/j.acra.2011.04.002. Epub 2011 Jun 11.
The purpose of the present study was to evaluate the imaging findings of triple-negative breast cancer patients receiving neoadjuvant chemotherapy (NAC) and to investigate whether the findings are different between responders and nonresponders, enabling us to predict the final patient response.
The subjects included 22 women ages 35-73 years (mean, 50.4 years) with 23 triple-negative breast cancers who underwent NAC. In all cases, a mammography, ultrasound, and magnetic resonance imaging (MRI) were performed a total of three times: before NAC, after the first half of NAC, and after NAC. The mass shape, mass margin, presence of clear intratumoral necrosis, and presence of intratumoral calcification were analyzed. The presence of clear intratumoral necrosis was evaluated on the MRI. If there was a very high signal intensity (similar to that of water) in the tumor on the fat-suppressed T2-weighted MRI scans, we judged it to be clear intratumoral necrosis.
An irregularly shaped mass (P = .018) and the presence of clear intratumoral necrosis (P = .044) were significantly associated with NAC nonresponse in triple-negative breast cancer patients. The mass margin and the presence of intratumoral calcification were not related to the effects after NAC.
In cases of triple-negative breast cancer involving clear intratumoral necrosis with an irregular mass shape, it is predicted that the effects of neoadjuvant chemotherapy will likely be poor, and therefore, the presence of such image findings may be useful for determining the optimal application of neoadjuvant chemotherapy.
本研究旨在评估接受新辅助化疗（NAC）的三阴性乳腺癌患者的影像学表现，并探讨其在反应者和无反应者之间是否存在差异，从而预测患者的最终反应。
本研究共纳入 22 例年龄 35-73 岁（平均 50.4 岁）的女性患者，共 23 例三阴性乳腺癌患者接受 NAC。所有患者均接受了总共 3 次的乳腺 X 线摄影、超声和磁共振成像（MRI）检查：NAC 前、NAC 后 1/2 时和 NAC 后。分析了肿块形态、肿块边缘、是否存在清晰的肿瘤内坏死以及肿瘤内钙化的存在。MRI 上评估是否存在清晰的肿瘤内坏死。如果在脂肪抑制 T2 加权 MRI 扫描上肿瘤内存在非常高的信号强度（类似于水），则判断为清晰的肿瘤内坏死。
不规则形状的肿块（P =.018）和清晰的肿瘤内坏死的存在（P =.044）与三阴性乳腺癌患者的 NAC 无反应显著相关。肿块边缘和肿瘤内钙化的存在与 NAC 后的效果无关。
在三阴性乳腺癌中，若存在肿瘤内坏死且肿块形状不规则，则预计新辅助化疗的效果可能较差，因此，存在这些影像学表现可能有助于确定新辅助化疗的最佳应用。
