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Updated: Jan 21, 2026
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Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
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MRI does not predict pathologic complete response after neoadjuvant chemotherapy for breast cancer
Stephen F Sener1,2, Rachel E Sargent1,2, Connie Lee1,2
1Los Angeles County+University of Southern California (LAC+USC) Medical Center, Los Angeles, California.
Journal of Surgical Oncology
|August 11, 2019
Summary
Magnetic resonance imaging (MRI) cannot reliably predict pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) for breast cancer. Radiographic complete response (rCR) on MRI is not an accurate surrogate for pCR, with many patients showing residual disease.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Assessing treatment response in breast cancer patients undergoing neoadjuvant chemotherapy (NAC) is critical.
- Standardized MRI protocols and expert interpretation are essential for evaluating treatment efficacy.
Purpose of the Study:
- To determine if magnetic resonance imaging (MRI) can accurately predict pathologic complete response (pCR) after NAC in breast cancer.
- To evaluate the accuracy of radiographic complete response (rCR) as a surrogate for pCR.
Main Methods:
- Retrospective analysis of 102 breast cancer patients treated with NAC (2015-2018).
- Pre- and post-NAC MRI performed on the same equipment with a consistent protocol.
- pCR defined as absence of invasive cancer or DCIS in breast/lymph nodes (ypT0N0M0); rCR defined as absence of suspicious MRI findings.
Main Results:
- 43.1% of patients achieved rCR, while 40.1% achieved pCR.
- MRI demonstrated a positive predictive value of 84.5% and a negative predictive value of 72.7% for pCR.
- 27.3% of patients with rCR on MRI had residual cancer detected pathologically.
Conclusions:
- Radiographic complete response (rCR) on MRI is not a sufficiently accurate surrogate marker for pathologic complete response (pCR) after neoadjuvant chemotherapy.
- Clinical decisions should not solely rely on MRI-based rCR for assessing NAC treatment success in breast cancer.
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