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Updated: Jun 20, 2026

Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
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Interim Breast MRI for Predicting Pathologic Complete Response After Neoadjuvant Chemotherapy in Early Breast Cancer.

Eri Kato1, Hideo Shigematsu1, Ai Amioka1

  • 1Department of Surgical Oncology, Hiroshima University, Research Institute for Radiation Biology and Medicine, Hiroshima, Japan.

European Journal of Breast Health
|June 19, 2026
PubMed
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Interim magnetic resonance imaging (MRI) can accurately predict pathological complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy (NAC), aiding early treatment decisions. While effective, its high false-positive rate requires caution for surgical de-escalation planning.

Area of Science:

  • Oncology
  • Radiology
  • Medical Imaging

Background:

  • Accurate prediction of pathological complete response (pCR) to neoadjuvant chemotherapy (NAC) is crucial for breast cancer treatment decisions.
  • The utility of integrated models combining interim MRI findings with clinicopathological factors for pCR prediction is not well-established.

Purpose of the Study:

  • To compare the efficacy of interim and post-NAC MRI in predicting pCR.
  • To evaluate prediction models integrating MRI and clinicopathological variables for pCR prediction.

Main Methods:

  • Retrospective analysis of 249 early-stage breast cancer patients who underwent serial MRI scans (pre-, interim-, and post-NAC).
  • Development of four predictive models: clinicopathological variables alone, with interim MRI, with post-NAC MRI, and with both.
Keywords:
Breast neoplasmsmagnetic resonance imagingneoadjuvant therapypathologic complete responsepredictive value of tests

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  • Performance assessment using ROC analysis, calibration plots, and decision curve analysis.

    • Main Results:

    • pCR was achieved by 25% of patients.
    • Models incorporating MRI significantly improved pCR prediction compared to clinicopathological factors alone (AUCs: 0.721 to 0.848).
    • Interim MRI models showed high sensitivity (0.99) and NPV (0.97), enabling early pCR identification with performance comparable to post-NAC MRI.

    Conclusions:

    • Interim MRI offers comparable pCR predictive performance to post-NAC MRI, supporting its use for early treatment adjustments.
    • While interim MRI is valuable for early prediction, its high false-positive rate necessitates caution when considering surgical de-escalation.