对新辅助化疗的完整乳房MRI反应和对病理完整反应的预测
Christina A Chen1, Jessica H Hayward1, Genevieve A Woodard2
1University of California San Francisco, Department of Radiology and Medical Imaging, San Francisco, CA.
Journal of breast imaging
|March 1, 2024
概括
乳房MRI在经过新辅助化疗后检测残留癌症的准确率为53%. 负预测值 (NPV) 根据瘤亚型而异,三阴性乳腺癌显示最高的NPV.
科学领域:
- 在瘤学瘤学.
- 放射学 放射学是指放射学
- 乳腺癌研究研究 乳腺癌研究
背景情况:
- 新辅助化疗 (NAC) 是侵袭性乳腺癌的标准治疗方法.
- 通过成像评估治疗反应对于指导进一步管理至关重要.
- 乳房MRI用于评估NAC之后的瘤反应.
研究的目的:
- 为了确定乳腺MRI的负预测值 (NPV),在NAC后识别残留的侵入性乳腺癌.
- 为了分析乳腺MRI的NPV跨乳腺癌的不同分子亚型.
主要方法:
- 对244名侵袭性乳腺癌患者进行了回顾性研究,这些患者接受了NAC治疗.
- 完整的MRI反应被定义为没有NAC后的残留增强.
- NPV计算为完整MRI响应者中真负的比例,与病理完整响应 (pCR) 相对应.
主要成果:
- 16%的患者实现了完全的MRI反应;其中53%的患者有pCR.
- 总的来说,NPV不足以避免手术切除.
- 根据亚型,NPV有很大的差异:HR+/HER2- (20%),HR+/HER2+ (30%),HR-/HER+ (75%) 和三负 (TN) (90%).
结论:
- 在NAC后的完整MRI反应具有53%的PCR率,表明避免手术的效用有限.
- 乳房MRI为特定的分子亚型提供预后价值.
- 三阴性乳腺癌显示最高的NPV,这表明MRI在这个子组中可能更可靠.
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