학술논문

Assessing the accuracy of conventional gadolinium‐enhanced breast MRI in measuring the nodal response to neoadjuvant chemotherapy (NAC) in breast cancer.
Document Type
Article
Source
Breast Journal. Nov2020, Vol. 26 Issue 11, p2151-2156. 6p.
Subject
*BREAST tumors
*CANCER chemotherapy
*COMBINED modality therapy
*LYMPH nodes
*MAGNETIC resonance imaging
*TREATMENT effectiveness
*CONTRAST media
*RETROSPECTIVE studies
*DESCRIPTIVE statistics
Language
ISSN
1075-122X
Abstract
Management of the axilla in the era of neoadjuvant chemotherapy for breast cancer is evolving. The aim of this study is to determine if conventional gadolinium‐enhanced breast MRI can aid in evaluation of the response to neoadjuvant chemotherapy in the axilla. A retrospective review of a prospectively maintained database of patients undergoing neoadjuvant chemotherapy for breast cancer was performed. Pre and post‐neoadjuvant chemotherapy MRI reports for node‐positive patients were examined in conjunction with demographic data, treatment type, and final histopathology reports. One‐hundred and fourteen patients with breast cancer undergoing neoadjuvant chemotherapy were included in the study. The sensitivity of magnetic resonance imaging in detecting nodal response post‐neoadjuvant chemotherapy was 33.93% and the specificity was 82.76%. Magnetic resonance imaging had a positive predictive value of 65.52% and a negative predictive value of 56.47%. MRI was found to be most specific in the detection of triple‐negative cancer response. Specificity was 100% in this group and sensitivity was 75%. Magnetic resonance imaging has a relatively high specificity in detecting nodal response post‐neoadjuvant chemotherapy but has a low sensitivity. Alone it cannot be relied upon to identify active axillary malignancy post‐neoadjuvant chemotherapy. However, given its increased specificity among certain subgroups, it may have a role in super‐selecting patients suitable for sentinel lymph node biopsy post‐neoadjuvant chemotherapy. [ABSTRACT FROM AUTHOR]