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Ability of MRI Breast to Predict Pathologic Complete Response Following Neoadjuvant Systemic Therapy in Patients with
Anu L Joy1, Teena Sleeba2, Anu S Easo3
1Department of General Medicine, Basingstoke and North Hampshire Hospital, Basingstoke, United Kingdom.
The Indian Journal of Radiology & Imaging
|June 25, 2026
Summary
Magnetic resonance imaging (MRI) shows promise in predicting pathological complete response (pCR) after neoadjuvant systemic therapy (NST) for breast cancer. Combining MRI with vacuum-assisted core biopsy (VACB) may help identify patients who can avoid surgery.
Area of Science:
- Oncology
- Radiology
- Pathology
Background:
- Neoadjuvant systemic therapy (NST) improves breast cancer outcomes, with some patients achieving pathological complete response (pCR).
- Accurate identification of pCR is crucial to potentially spare patients unnecessary surgery.
- Current imaging methods have limitations in precisely assessing treatment response.
Purpose of the Study:
- To review the predictive ability of MRI in assessing pCR after NST for breast cancer.
- To explore the role of MRI-guided vacuum-assisted core biopsy (VACB) as an adjunct to improve pCR prediction.
Main Methods:
- Narrative literature review focusing on MRI's performance in predicting pCR post-NST.
- Evaluation of combined diffusion-weighted and contrast-enhanced MRI techniques.
- Assessment of vacuum-assisted core biopsy (VACB) as a complementary diagnostic tool.
Main Results:
- MRI demonstrates high sensitivity and specificity in detecting residual disease post-NST, outperforming conventional imaging.
- Combined MRI techniques enhance diagnostic accuracy for monitoring chemotherapy response.
- MRI-guided VACB shows high negative predictive value and minimal invasiveness, improving diagnostic certainty.
Conclusions:
- Integrated MRI and VACB approaches show potential for accurately predicting pCR post-NST.
- This combined strategy may help personalize treatment decisions and reduce avoidable surgeries for breast cancer patients.
- Further research is needed to establish the clinical utility of this combined approach.