Abstract
Background:Neoadjuvant chemotherapy for breast cancer was short of recognized treatment scheme and prediction factor. Diffusion weighted magnetic imaging can predict treatment response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy. Methods:Fifty patients of breast cancer (mean age, 48.7 years) with stage II-III who underwent neoadjuvant chemotherapy and preoperative MRI were retrospectively evaluated between 2016 and 2020. Association between preoperative breast MRI findings or clinicopathological features and effect of neoadjuvant chemotherapy were studied. Risk factors were identified by multivariate logistic regression analysis. Results:Multivariate logistics regression analysis showed that clinical stage (OR, 0.104; 95% CI: 0.021, 0.516; p=0.006) at baseline and standard apparent diffusion coefficient (ADC) change (OR, 9.865; 95% CI: 1.024, 95.021; p=0.048) were predictive factors of neoadjuvant chemotherapy. The percentage of standard ADC value increasing in pCR group was larger than that in non-pCR group at first time point (p<0.05). The AUC of ROC curve was 0.828 (95% CI: 0.681, 0.975; p<0.05). In pCR group, change of standard ADC values was greater compared with that in tumor size at first follow-up (p<0.05). It was correlation between change of standard ADC values and tumor diameter at first follow-up (r, 0.438; p<0.05). Triple-negative patients in pCR group had higher change of standard ADC values than that in non-pCR groupat first follow-up (p>0.05).Conclusion:Standard ADC values change, clinical stage at baseline were closely related to the effect of neoadjuvant chemotherapy. The change of standard ADC values advanced reduction of tumor size at first follow-up and can predict effect of neoadjuvant chemotherapy in the early stage.
Locally advanced breast cancer treated with neoadjuvant chemotherapy: Is breast-conserving surgery feasible?