Akiko Shimauchi MD, Presenter: Nothing to Disclose

Hiroyuki Abe MD, Abstract Co-Author: Nothing to Disclose

Federico Pineda BS, Abstract Co-Author: Nothing to Disclose

David Victor Schacht MD, Abstract Co-Author: Nothing to Disclose

Charlene A. Sennett MD, Abstract Co-Author: Nothing to Disclose

Gillian Maclaine Newstead MD, Abstract Co-Author: Medical Advisory Board, Bayer AG Consultant, Three Palm Software LLC

Kirti Manohar Kulkarni MD, Abstract Co-Author: Nothing to Disclose

To investigate the change of breast parenchymal enhancement (BPE) on MRI, in the contralateral normal breast of patients who received neoadjuvant chemotherapy (NAC) for breast cancer.

20 patients with breast cancer (mean age, 57 years; age range, 35-87 years) treated with NAC who had pre-chemo and post-chemo (pre-surgery) MRI between Jan 2010 and Jan 2012 were reviewed retrospectively. BPE of the contralateral normal breast was analyzed using Dynacad. Regions of interest (ROIs) were traced manually on pre and 5 dynamic T1WI post contrast series , at the same 4 locations of the normal breast on pre-NAC and post-NAC scans. Average relative increase in intensity (%) compared to the intensity on precontrast images within the ROIs was obtained at each of the 5 post contrast time points, and the values from the 4 ROIs were averaged to give a single mean relative signal increase per scan. The effect of NAC on the change of BPE was evaluated using the student t test. Change in categorical scales (minimal, mild, moderate or marked) to rate BPE by radiologists was also evaluated, using the Chi-square test.   Subgroup analysis based on menopausal status (premenopausal (n=8), postmenopausal (n=12)) was performed.

The average relative signal increase at the 5 time points were 15.2, 31.1, 39.7, 46.2 and 50.5% on pre-NAC scans, and 5.7, 14.9, 20.1, 23.4 and 26.2% on post-NAC scans. Statistically significant differences were found at all time points (p=0.013, 0.002, 0.001, <0.001, <0.001 at each time point respectively). The numbers of cases categorized into minimal, mild, moderate, and marked BPE were 4, 10, 6, and 0 on pre-NAC scans, and 17, 3, 0, and 0 cases respectively on post-NAC scans, with a statistically significant difference (p<0.001) in the distribution. In both premenopausal and post menopausal subgroups, a statistically significant decrease in average relative signal increase was found at the 2nd through 5th time points.

BPE in the contralateral normal breast showed a statistically significant decrease after NAC compared to pre-NAC scans, both in early and delayed postcontrast images. The significant decrease was seen regardless of menopausal status.

Evaluation of functional changes in breast tissue due to NAC may improve the understanding of the influence of NAC on hormonal levels and hemodynamics in pre and post menopausal breast cancer patients

Shimauchi, A, Abe, H, Pineda, F, Schacht, D, Sennett, C, Newstead, G, Kulkarni, K, MR Imaging of Breast before and after Neoadjuvant Chemotherapy: Does Breast Parenchymal Enhancement in the Contralateral Normal Breast Change after Chemotherapy?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13015067.html