Imaging Predicts Breast Cancer Response to Chemotherapy

Magnetic resonance imaging better than clinical assessment for women undergoing pre-op chemo

WEDNESDAY, May 23 (HealthDay News) -- For women with breast cancer undergoing neoadjuvant chemotherapy before surgery, measurements taken by magnetic resonance imaging (MRI) predict clinical response better than clinical assessment, according to a study published in the June issue of Radiology.

Nola M. Hylton, Ph.D., from the University of California San Francisco, and colleagues compared the ability of MRI and clinical assessment to predict response to chemotherapy in 216 women undergoing neoadjuvant chemotherapy before surgery for breast cancer. Imaging was performed at four time points: before neoadjuvant chemotherapy; after one cycle of anthracycline-based treatment; after anthracycline-based treatment and before taxane treatment; and after all chemotherapy.

The researchers found that size measurements by MRI were superior to clinical assessment in predicting pathologic complete response and residual cancer burden. Tumor volume change after anthracycline-based treatment (second examination) showed the greatest relative benefit. For the prediction of pathologic complete response, the multivariate-adjusted area under the receiver operating characteristic curve was 0.70 for volume alone at the second examination. This increased to 0.73 when all four predictor variables were used, and improved to 0.84 when adjusting for age and race and including both MRI and clinical measurements.

"MRI findings are a stronger predictor of pathologic response to neoadjuvant chemotherapy than clinical assessment, with the greatest advantage observed with the use of volumetric measurement of tumor response early in treatment," Hylton and colleagues conclude.

Several authors disclosed financial or consulting relationships with medical device and imaging companies.

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