Breast-Conserving Surgery After Chemotherapy: Value of MDCT for Determining Tumor Distribution and Shrinkage Pattern

Tozaki, Mitsuhiro; Kobayashi, Tadashi; Uno, Shinji; Aiba, Keisuke; Takeyama, Hiroshi; Shioya, Hisashi; Tabei, Isao; Toriumi, Yasuo; Suzuki, Masafumi; Fukuda, Kunihiko

doi:10.2214/ajr.04.1520

Cited by 41 publications

(39 citation statements)

References 15 publications

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“…Findings of previous studies have demonstrated the usefulness of imaging modalities for determining the tumor distribution of residual breast carcinoma following NAC (7)(8)(9)(10)(11)(12). A study by Tozaki et al (9) analyzed computed tomography (CT) findings of tumor distribution patterns of locally-advanced breast carcinomas prior and subsequent to NAC.…”

Section: Introductionmentioning

confidence: 99%

“…A study by Tozaki et al (9) analyzed computed tomography (CT) findings of tumor distribution patterns of locally-advanced breast carcinomas prior and subsequent to NAC. The distribution patterns of the enhancing lesions of breast carcinomas prior to NAC were classified into five categories: Solitary, grouped, separated, mixed and replaced lesions; and the shrinkage patterns subsequent to NAC were classified into three categories: Concentric shrinkage with or without surrounding lesions and shrinkage with residual multinodular lesions (9). The study concluded that CT classification of tumor distribution prior to NAC and shrinkage patterns subsequent to NAC is important for the evaluation of the residual lesions undergoing breast-conserving surgery (9).…”

Section: Introductionmentioning

confidence: 99%

“…The distribution patterns of the enhancing lesions of breast carcinomas prior to NAC were classified into five categories: Solitary, grouped, separated, mixed and replaced lesions; and the shrinkage patterns subsequent to NAC were classified into three categories: Concentric shrinkage with or without surrounding lesions and shrinkage with residual multinodular lesions (9). The study concluded that CT classification of tumor distribution prior to NAC and shrinkage patterns subsequent to NAC is important for the evaluation of the residual lesions undergoing breast-conserving surgery (9). In addition, Kim et al (12) recently reported magnetic resonance imaging (MRI) patterns of breast carcinomas prior and subsequent to NAC, and analyzed the correlation with pathological response grading.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Magnetic resonance imaging shrinkage patterns following neoadjuvant chemotherapy for breast carcinomas with an emphasis on the radiopathological correlations

Tomida

Ishida

Umeda

et al. 2014

Molecular and Clinical Oncology

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Abstract. Preoperative neoadjuvant chemotherapy (NAC) is considered to be the standard treatment for locally-advanced breast carcinomas. Obtaining precise information regarding the tumor extent and distribution by imaging modalities to assess the success of breast-conserving surgery following NAC is extremely important. Analysis of the detailed radiopathological correlation of magnetic resonance imaging (MRI) following NAC has not been reported previously. The MRI and histopathological shrinkage patterns of residual breast carcinomas in 27 consecutive cases were analyzed following NAC and classified into five categories: Types I and II (concentric shrinkage with and without surrounding lesions, respectively); type III (shrinkage with residual multinodular lesions); type IV (diffuse contrast enhancement in whole quadrant); and non-visualization. The present study clearly demonstrated that the most common MRI shrinkage pattern was type I (11 cases), followed by type II and non-visuali zation, and the most common histopathological shrinkage pattern was type II (11 cases), followed by type III (8 cases). The concordance rate between MRI and pathological patterns was 48% and the worst concordance MRI pattern was type I. MRI is considered to be a useful method for evaluation of the residual carcinoma following NAC. However, the concordance rate was low in the MRI pattern I cases and tiny foci of residual carcinoma were present in half of the non-visualization cases, as shown by MRI. Therefore, the tumor extent must be completely resected for patients who undergo NAC, and postoperative radiation may be important for preventing local recurrence of breast carcinoma.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Magnetic resonance imaging shrinkage patterns following neoadjuvant chemotherapy for breast carcinomas with an emphasis on the radiopathological correlations

Tomida

Ishida

Umeda

et al. 2014

Molecular and Clinical Oncology

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show abstract

“…MRI and CT have recently developed the potential to assist the other traditional imaging methods in the evaluation of response to NAC [12]- [20]. By mammography, it is difficult to identify a mass lesion in dense breasts or to distinguish a viable lesion from a fibrous reaction owing to NAC.…”

Section: Discussionmentioning

confidence: 99%

Optimization of Digital Breast Tomosynthesis (DBT) for Breast Cancer Diagnosis

Uchiyama¹,

Kinoshita²,

Hojo³

et al. 2012

Mammography - Recent Advances

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“…Breast cancer can be classified into several patterns based on morphology (5,(15)(16)(17). In addition, the pattern of response to NAC depends largely on the initial morphology (15,16).…”

Section: Introductionmentioning

confidence: 99%

Diffusion-weighted magnetic resonance imaging for assessment after neoadjuvant chemotherapy in breast cancer, based on morphological concepts

Murata

Kubota²,

Hamada³

et al. 2010

Oncology Letters

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Abstract. The study aimed to evaluate the utility of diffusionweighted imaging (DWI) and to assess the response of breast cancer patients to neoadjuvant chemotherapy (NAC), based on morphological concepts. This retrospective study included 35 breast cancer patients (36 lesions) who had conventional magnetic resonance imaging (MRI), with DWI acquired before and after NAC. The morphological pattern of delayed enhancement on MRI before NAC was classified into two types: focal mass (FM), and multiple masses and/or non-mass like (MM/NM), based on Breast Imaging Reporting and Data System (BI-RADS). Of the 36 tumors, 26 were classified as FM and 10 as MM/NM. Tumors were clearly visualized on the initial DWI although one case of suspected MM/NM was not observed on DWI following NAC. A correlation was found between changes in the apparent diffusion coefficient and response rates to NAC in FM tumors (r=0.608, p<0.001), but not in MM/NM tumors (r=0.141, p=0.717). There was agreement between MRI findings after NAC and pathological findings in 30 of the 36 tumors (83.3%). Thus, we concluded that DWI is potentially useful in assessing the response to NAC for breast cancer for tumors diagnosed as FM on the initial conventional MRI.

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Breast-Conserving Surgery After Chemotherapy: Value of MDCT for Determining Tumor Distribution and Shrinkage Pattern

Abstract: MDCT classification of tumor distribution before neoadjuvant chemotherapy and of shrinkage patterns after neoadjuvant chemotherapy is important in the preoperative evaluation of patients undergoing breast-conserving surgery.

Cited by 41 publications

References 15 publications

Magnetic resonance imaging shrinkage patterns following neoadjuvant chemotherapy for breast carcinomas with an emphasis on the radiopathological correlations

Magnetic resonance imaging shrinkage patterns following neoadjuvant chemotherapy for breast carcinomas with an emphasis on the radiopathological correlations

Optimization of Digital Breast Tomosynthesis (DBT) for Breast Cancer Diagnosis

Diffusion-weighted magnetic resonance imaging for assessment after neoadjuvant chemotherapy in breast cancer, based on morphological concepts

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