Association Between Background Parenchymal Enhancement and Pathologic Complete Remission Throughout the Neoadjuvant Chemotherapy in Breast Cancer Patients

Chao You; Weijun Peng; Wenxiang Zhi; Min He; Guangyu Liu; Li Xie; Luan Jiang; Xiaoxin Hu; Xuxia Shen; Yajia Gu

doi:10.1016/j.tranon.2017.07.005

Association Between Background Parenchymal Enhancement and Pathologic Complete Remission Throughout the Neoadjuvant Chemotherapy in Breast Cancer Patients

Transl Oncol. 2017 Oct;10(5):786-792. doi: 10.1016/j.tranon.2017.07.005. Epub 2017 Aug 12.

Authors

Chao You¹, Weijun Peng¹, Wenxiang Zhi², Min He³, Guangyu Liu³, Li Xie⁴, Luan Jiang⁵, Xiaoxin Hu¹, Xuxia Shen⁶, Yajia Gu⁷

Affiliations

¹ Department of Radiology, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
² Department of Ultrasound, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
³ Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
⁴ Statistical Office, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China.
⁵ Center for Advanced Medical Imaging Technology, Shanghai Advanced Research Institute, Chinese Academy of Sciences, Shanghai, PR China.
⁶ Department of Pathology, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University Shanghai, PR China.
⁷ Department of Radiology, Fudan University Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, PR China. Electronic address: cjr.guyajia@vip.163.com.

Abstract

Purpose: To retrospectively investigate the quantitative background parenchymal enhancement (BPE) of the contralateral normal breast in patients with unilateral invasive breast cancer throughout multiple monitoring points of neoadjuvant chemotherapy (NAC) and to further determine whether BPE is associated with tumor response, especially at the early stage of NAC.

Materials and methods: A total of 90 patients with unilateral breast cancer who then received six or eight cycles of NAC before surgery were analyzed retrospectively. BPE was measured in dynamic contrast-enhanced MRI at baseline and after 2nd, 4th, and 6th NAC, respectively. Correlation between BPE and tumor size was analyzed, and the association between pathologic complete remission (pCR) and BPE was also analyzed.

Results: The BPE of contralateral normal breast showed a constant reduction throughout NAC therapy regardless of the menopausal status (P<.001 in all). Both the BPEs and the changes of BPE in each of the three monitoring points were significantly correlated with those in tumor size (P<.05 in all), and the reduction of BPE after 2nd NAC had the largest diagnostic value for pCR (AUC=0.726, P<.001), particularly in hormonal receptor (HR)-negative patients (OR=0.243, 95%CI=0.083 to 0.706, P=.009).

Conclusion: The BPE of contralateral normal breast had a constant decreased tendency similar to the change of tumor size in NAC. Reduction of BPE at the early stage of NAC was positively associated with pCR, especially in HR-negative status.