Chiara Iacconi MD, Presenter: Nothing to Disclose

Punam Bajaj MD, MBBS, Abstract Co-Author: Nothing to Disclose

Elizabeth A. Morris MD, Abstract Co-Author: Nothing to Disclose

D. David Dershaw MD, Abstract Co-Author: Nothing to Disclose

To analyze a possible correlation between morphology prior to treatment, RECIST response, volumetric reduction, shrinkage pattern and disease free survival (DFS) in locally advanced breast cancers (LABC).

This is a retrospective analysis of 52 women (mean age 44 years, range: 31-69 years) with LABC who had breast MR before and after neoadjuvant chemotherapy. Dynamic breast MR was acquired using 1.5 or 3 T scanners with dedicated breast coils. 3D-tumor volume measurements were done with automated segmentation of MR images using Sentinelle Aegis 2.0.1. Morphology of tumor at diagnosis (solitary, grouped in same quadrant , separated in different quadrants , total breast replaced by tumor), response to treatment according to RECIST, volumetric response (complete, partial volume reduction: 65-99%, stable: volume reduction < 64%) as well as shrinkage pattern (no residual enhancement, concentric shrinkage, concentric with surrounding lesions, multinodular lesions, diffuse enhancement of the breast) were evaluated and correlated to DFS defined in months after the end of chemotherapy. DFS was evaluated on mammography and PET-CT or total- body CT. Receptor status was also correlated to DFS. Pathological response was defined according to pathology report. Mantel-Cox test was used for the statistical analysis.

Agreement in the evaluation of treatment response between diameter at MR and pathology was observed in 38/52 (73%), overestimated in 4/52 (8%) and underestimated in 10/52(19%). Tumor morphology at diagnosis did not significantly correlate to DFS (p=0.33). RECIST versus volumetric response in women with complete, partial or stable disease did not significantly affect the DFS (p=0.6, 0.24 and 0.31 respectively). DFS was independent of shrinkage pattern of tumors (p=0.69). No statistical difference in DFS was found between complete and residual pathologic response (p= 0.76). The percentage of volume reduction was higher in triple negative cancers compared to others (p=0.003), but DFS was significantly lower (27 months) than the other group (66 months)( p=0.04).

DFS in LABC is not related to pre and post treatment breast MR morphology.

DFS in locally advanced breast cancer is better predicted by tumor receptor status than tumor morphology at MR, both prior to and after treatment. 

Iacconi, C, Bajaj, P, Morris, E, Dershaw, D, Does Morphologic and Volumetric MR Tumor Response in Locally Advanced Breast Cancers Correlate with Disease Free Survival?.  Radiological Society of North America 2013 Scientific Assembly and Annual Meeting, December 1 - December 6, 2013 ,Chicago IL. http://archive.rsna.org/2013/13019042.html