Magnetic Resonance Imaging Response Monitoring of Breast Cancer During Neoadjuvant Chemotherapy: Relevance of Breast Cancer Subtype
To evaluate the relevance of breast cancer subtypes for magnetic resonance imaging (MRI) markers for monitoring of therapy response during neoadjuvant chemotherapy (NAC). MRI examinations were performed in 188 women before and during NAC. MRI interpretation included lesion morphology at baseline, ch...
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| Veröffentlicht in: | Journal of clinical oncology 2011-02, Vol.29 (6), p.660-666 |
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| creator | LOO, Claudette E STRAVER, Marieke E RODENHUIS, Sjoerd MULLER, Sara H WESSELING, Jelle VRANCKEN PEETERS, Marie-Jeanne T. F. D GILHUIJS, Kenneth G. A |
| description | To evaluate the relevance of breast cancer subtypes for magnetic resonance imaging (MRI) markers for monitoring of therapy response during neoadjuvant chemotherapy (NAC).
MRI examinations were performed in 188 women before and during NAC. MRI interpretation included lesion morphology at baseline, changes in morphology, size, and contrast uptake kinetics (initial and late enhancement). By using immunohistochemistry, tumors were divided into three subtypes: triple negative, human epidermal growth factor receptor 2 (HER2) positive, and estrogen receptor (ER) positive/HER2 negative. Tumor response was assessed dichotomously (ie, presence or absence of residual tumor in the surgical specimen). Complementary, a continuous scale assessment was used (the breast response index [BRI], representing the relative change in tumor stage). Multivariate regression analysis and receiver operating characteristic analysis were employed to establish significant associations.
Residual tumor at pathology was present in 31 (66%) of 47 triple-negative tumors, 23 (61%) of 38 HER2-positive tumors, and 96 (93%) of 103 ER-positive/HER2-negative tumors. Multivariate analysis of residual disease showed significant associations between breast cancer subtype and MRI (area under the curve [AUC], 0.84; P < .001). BRI also showed significant correlation among breast cancer subtype, MRI, and age (Pearson's r = 0.465; P < .001). In subset analysis, this was only significant for triple-negative tumors (P < .001) and HER2-positive tumors (P < .05). Residual tumor after NAC in the triple-negative and HER2-positive group is significantly associated with the change in largest diameter of late enhancement during NAC (AUC, 0.76; P < .001). No associations were found for ER-positive/HER2-negative tumors.
MRI during NAC to monitor response is effective in triple-negative or HER2-positive disease but is inaccurate in ER-positive/HER2-negative breast cancer. |
| doi_str_mv | 10.1200/JCO.2010.31.1258 |
| format | Article |
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MRI examinations were performed in 188 women before and during NAC. MRI interpretation included lesion morphology at baseline, changes in morphology, size, and contrast uptake kinetics (initial and late enhancement). By using immunohistochemistry, tumors were divided into three subtypes: triple negative, human epidermal growth factor receptor 2 (HER2) positive, and estrogen receptor (ER) positive/HER2 negative. Tumor response was assessed dichotomously (ie, presence or absence of residual tumor in the surgical specimen). Complementary, a continuous scale assessment was used (the breast response index [BRI], representing the relative change in tumor stage). Multivariate regression analysis and receiver operating characteristic analysis were employed to establish significant associations.
Residual tumor at pathology was present in 31 (66%) of 47 triple-negative tumors, 23 (61%) of 38 HER2-positive tumors, and 96 (93%) of 103 ER-positive/HER2-negative tumors. Multivariate analysis of residual disease showed significant associations between breast cancer subtype and MRI (area under the curve [AUC], 0.84; P < .001). BRI also showed significant correlation among breast cancer subtype, MRI, and age (Pearson's r = 0.465; P < .001). In subset analysis, this was only significant for triple-negative tumors (P < .001) and HER2-positive tumors (P < .05). Residual tumor after NAC in the triple-negative and HER2-positive group is significantly associated with the change in largest diameter of late enhancement during NAC (AUC, 0.76; P < .001). No associations were found for ER-positive/HER2-negative tumors.
MRI during NAC to monitor response is effective in triple-negative or HER2-positive disease but is inaccurate in ER-positive/HER2-negative breast cancer.</description><identifier>ISSN: 0732-183X</identifier><identifier>EISSN: 1527-7755</identifier><identifier>DOI: 10.1200/JCO.2010.31.1258</identifier><identifier>PMID: 21220595</identifier><language>eng</language><publisher>Alexandria, VA: American Society of Clinical Oncology</publisher><subject>Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Area Under Curve ; Biological and medical sciences ; Breast Neoplasms - drug therapy ; Breast Neoplasms - genetics ; Breast Neoplasms - pathology ; Female ; Genes, erbB-2 ; Gynecology. Andrology. Obstetrics ; Humans ; Image Interpretation, Computer-Assisted ; Magnetic Resonance Imaging ; Mammary gland diseases ; Medical sciences ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm, Residual ; Receptors, Estrogen - genetics ; Tumors ; Young Adult</subject><ispartof>Journal of clinical oncology, 2011-02, Vol.29 (6), p.660-666</ispartof><rights>2015 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c424t-9fec8b0213769d7515aff03344ca1c15be97a2f3d3797f3bcf0ef1121bc0964f3</citedby><cites>FETCH-LOGICAL-c424t-9fec8b0213769d7515aff03344ca1c15be97a2f3d3797f3bcf0ef1121bc0964f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,3716,27905,27906</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23910884$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21220595$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>LOO, Claudette E</creatorcontrib><creatorcontrib>STRAVER, Marieke E</creatorcontrib><creatorcontrib>RODENHUIS, Sjoerd</creatorcontrib><creatorcontrib>MULLER, Sara H</creatorcontrib><creatorcontrib>WESSELING, Jelle</creatorcontrib><creatorcontrib>VRANCKEN PEETERS, Marie-Jeanne T. F. D</creatorcontrib><creatorcontrib>GILHUIJS, Kenneth G. A</creatorcontrib><title>Magnetic Resonance Imaging Response Monitoring of Breast Cancer During Neoadjuvant Chemotherapy: Relevance of Breast Cancer Subtype</title><title>Journal of clinical oncology</title><addtitle>J Clin Oncol</addtitle><description>To evaluate the relevance of breast cancer subtypes for magnetic resonance imaging (MRI) markers for monitoring of therapy response during neoadjuvant chemotherapy (NAC).
MRI examinations were performed in 188 women before and during NAC. MRI interpretation included lesion morphology at baseline, changes in morphology, size, and contrast uptake kinetics (initial and late enhancement). By using immunohistochemistry, tumors were divided into three subtypes: triple negative, human epidermal growth factor receptor 2 (HER2) positive, and estrogen receptor (ER) positive/HER2 negative. Tumor response was assessed dichotomously (ie, presence or absence of residual tumor in the surgical specimen). Complementary, a continuous scale assessment was used (the breast response index [BRI], representing the relative change in tumor stage). Multivariate regression analysis and receiver operating characteristic analysis were employed to establish significant associations.
Residual tumor at pathology was present in 31 (66%) of 47 triple-negative tumors, 23 (61%) of 38 HER2-positive tumors, and 96 (93%) of 103 ER-positive/HER2-negative tumors. Multivariate analysis of residual disease showed significant associations between breast cancer subtype and MRI (area under the curve [AUC], 0.84; P < .001). BRI also showed significant correlation among breast cancer subtype, MRI, and age (Pearson's r = 0.465; P < .001). In subset analysis, this was only significant for triple-negative tumors (P < .001) and HER2-positive tumors (P < .05). Residual tumor after NAC in the triple-negative and HER2-positive group is significantly associated with the change in largest diameter of late enhancement during NAC (AUC, 0.76; P < .001). No associations were found for ER-positive/HER2-negative tumors.
MRI during NAC to monitor response is effective in triple-negative or HER2-positive disease but is inaccurate in ER-positive/HER2-negative breast cancer.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Area Under Curve</subject><subject>Biological and medical sciences</subject><subject>Breast Neoplasms - drug therapy</subject><subject>Breast Neoplasms - genetics</subject><subject>Breast Neoplasms - pathology</subject><subject>Female</subject><subject>Genes, erbB-2</subject><subject>Gynecology. Andrology. Obstetrics</subject><subject>Humans</subject><subject>Image Interpretation, Computer-Assisted</subject><subject>Magnetic Resonance Imaging</subject><subject>Mammary gland diseases</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoadjuvant Therapy</subject><subject>Neoplasm, Residual</subject><subject>Receptors, Estrogen - genetics</subject><subject>Tumors</subject><subject>Young Adult</subject><issn>0732-183X</issn><issn>1527-7755</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNplkE1v1DAURS1ERYeWPSuUDeoqrZ8dxzE7mPJR1FKpgMTOcjzPMxklcbCToln3j9dpB7pgZfm-c-_iEPIa6CkwSs--Lq9PGU0_DikQ1TOyAMFkLqUQz8mCSs5yqPivQ_Iyxi2lUFRcvCCHDBijQokFubsy6x7HxmY3GH1veovZRWfWTb-ek8H3EbMr3zejD3PmXfYhoIljtpzZkJ1PD_k39Ga1nW5Nny4b7Py4wWCG3bu00uLtw-5_3e9TPe4GPCYHzrQRX-3fI_Lz08cfyy_55fXni-X7y9wWrBhz5dBWNWXAZalWUoAwzlHOi8IasCBqVNIwx1dcKul4bR1FB8CgtlSVheNH5ORxdwj-94Rx1F0TLbat6dFPUVeCKWCl4Imkj6QNPsaATg-h6UzYaaB6Nq-TeT2b1xz0bD5V3uzHp7rD1b_CX9UJeLsHTLSmdSE5aOITxxXQqiqeuE2z3vxpAurYmbZNs0xvrWdKl7osKb8Hs0CZ8g</recordid><startdate>20110220</startdate><enddate>20110220</enddate><creator>LOO, Claudette E</creator><creator>STRAVER, Marieke E</creator><creator>RODENHUIS, Sjoerd</creator><creator>MULLER, Sara H</creator><creator>WESSELING, Jelle</creator><creator>VRANCKEN PEETERS, Marie-Jeanne T. F. D</creator><creator>GILHUIJS, Kenneth G. A</creator><general>American Society of Clinical Oncology</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110220</creationdate><title>Magnetic Resonance Imaging Response Monitoring of Breast Cancer During Neoadjuvant Chemotherapy: Relevance of Breast Cancer Subtype</title><author>LOO, Claudette E ; STRAVER, Marieke E ; RODENHUIS, Sjoerd ; MULLER, Sara H ; WESSELING, Jelle ; VRANCKEN PEETERS, Marie-Jeanne T. F. D ; GILHUIJS, Kenneth G. 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Obstetrics</topic><topic>Humans</topic><topic>Image Interpretation, Computer-Assisted</topic><topic>Magnetic Resonance Imaging</topic><topic>Mammary gland diseases</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoadjuvant Therapy</topic><topic>Neoplasm, Residual</topic><topic>Receptors, Estrogen - genetics</topic><topic>Tumors</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>LOO, Claudette E</creatorcontrib><creatorcontrib>STRAVER, Marieke E</creatorcontrib><creatorcontrib>RODENHUIS, Sjoerd</creatorcontrib><creatorcontrib>MULLER, Sara H</creatorcontrib><creatorcontrib>WESSELING, Jelle</creatorcontrib><creatorcontrib>VRANCKEN PEETERS, Marie-Jeanne T. F. D</creatorcontrib><creatorcontrib>GILHUIJS, Kenneth G. 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A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Magnetic Resonance Imaging Response Monitoring of Breast Cancer During Neoadjuvant Chemotherapy: Relevance of Breast Cancer Subtype</atitle><jtitle>Journal of clinical oncology</jtitle><addtitle>J Clin Oncol</addtitle><date>2011-02-20</date><risdate>2011</risdate><volume>29</volume><issue>6</issue><spage>660</spage><epage>666</epage><pages>660-666</pages><issn>0732-183X</issn><eissn>1527-7755</eissn><abstract>To evaluate the relevance of breast cancer subtypes for magnetic resonance imaging (MRI) markers for monitoring of therapy response during neoadjuvant chemotherapy (NAC).
MRI examinations were performed in 188 women before and during NAC. MRI interpretation included lesion morphology at baseline, changes in morphology, size, and contrast uptake kinetics (initial and late enhancement). By using immunohistochemistry, tumors were divided into three subtypes: triple negative, human epidermal growth factor receptor 2 (HER2) positive, and estrogen receptor (ER) positive/HER2 negative. Tumor response was assessed dichotomously (ie, presence or absence of residual tumor in the surgical specimen). Complementary, a continuous scale assessment was used (the breast response index [BRI], representing the relative change in tumor stage). Multivariate regression analysis and receiver operating characteristic analysis were employed to establish significant associations.
Residual tumor at pathology was present in 31 (66%) of 47 triple-negative tumors, 23 (61%) of 38 HER2-positive tumors, and 96 (93%) of 103 ER-positive/HER2-negative tumors. Multivariate analysis of residual disease showed significant associations between breast cancer subtype and MRI (area under the curve [AUC], 0.84; P < .001). BRI also showed significant correlation among breast cancer subtype, MRI, and age (Pearson's r = 0.465; P < .001). In subset analysis, this was only significant for triple-negative tumors (P < .001) and HER2-positive tumors (P < .05). Residual tumor after NAC in the triple-negative and HER2-positive group is significantly associated with the change in largest diameter of late enhancement during NAC (AUC, 0.76; P < .001). No associations were found for ER-positive/HER2-negative tumors.
MRI during NAC to monitor response is effective in triple-negative or HER2-positive disease but is inaccurate in ER-positive/HER2-negative breast cancer.</abstract><cop>Alexandria, VA</cop><pub>American Society of Clinical Oncology</pub><pmid>21220595</pmid><doi>10.1200/JCO.2010.31.1258</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Antineoplastic Combined Chemotherapy Protocols - therapeutic use Area Under Curve Biological and medical sciences Breast Neoplasms - drug therapy Breast Neoplasms - genetics Breast Neoplasms - pathology Female Genes, erbB-2 Gynecology. Andrology. Obstetrics Humans Image Interpretation, Computer-Assisted Magnetic Resonance Imaging Mammary gland diseases Medical sciences Middle Aged Neoadjuvant Therapy Neoplasm, Residual Receptors, Estrogen - genetics Tumors Young Adult |
| title | Magnetic Resonance Imaging Response Monitoring of Breast Cancer During Neoadjuvant Chemotherapy: Relevance of Breast Cancer Subtype |
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