Magnetic resonance imaging features of breast cancer according to intrinsic subtypes: correlations with neoadjuvant chemotherapy effects.

Hiroko Kawashima,Seiko Kitamura,Hiroyuki Furukawa,Masafumi Inokuchi,Hiroko Ikeda

doi:10.1186/2193-1801-3-240

Hiroko Kawashima, Seiko Kitamura + Show 3 more

Open Access

https://doi.org/10.1186/2193-1801-3-240

Copy DOI

Journal: SpringerPlus	Publication Date: May 9, 2014
Citations: 23	License type: CC BY 4.0

Affiliation: Kanazawa University, Kanazawa University Hospital

Abstract

PurposeThe purpose of this study was to evaluate the magnetic resonance imaging (MRI) features of breast cancer according to intrinsic subtypes and to investigate whether the MRI and immunohistochemical findings were related to neoadjuvant chemotherapy (NAC) effects.Materials and methodsThe MRI in 116 women with breast cancers who underwent NAC was reviewed. The mass margin, presence of intratumoral necrosis, tumor extension around the mass, relative signal enhancement (RSE), and kinetic curve pattern were analyzed. We investigated the possible correlations between MRI findings and the effects of NAC.ResultsAn irregular mass margin was significantly associated with luminal-A cancers, while a smooth mass margin was associated with human epidermal growth factor receptor2 (HER2) cancers. Intratumoral necrosis was significantly associated with triple-negative cancers. Tumor extension around the mass was significantly infrequent in luminal-B cancers and frequent in HER2 cancers. Luminal-B and HER2 cancers showed a significantly higher RSE at 2 min than Luminal-A cancers. Estrogen receptor (ER)-positive cancers, HER2-negative cancers, and presence of intratumoral necrosis were significantly associated with the NAC non-response.ConclusionsSeveral MR features can be used to predict the intrinsic subtype of breast cancers. ER-positivity, HER2-negativity, and presence of intratumoral necrosis were significantly associated with NAC non-response.

Highlights

It has become clear that breast cancers can be divided into biologically different intrinsic subtypes by gene expression analysis (Perou et al 2000; Sorlie et al 2001; Perou & Borresen-Dale 2011; Brenton et al 2005)
An irregular mass margin was significantly associated with luminal-A cancers, while a smooth mass margin was associated with human epidermal growth factor receptor2 (HER2) cancers
Intratumoral necrosis was significantly associated with triple-negative cancers

Summary

Introduction

It has become clear that breast cancers can be divided into biologically different intrinsic subtypes by gene expression analysis (Perou et al 2000; Sorlie et al 2001; Perou & Borresen-Dale 2011; Brenton et al 2005). It is common to determine the patient’s intrinsic subtype using an immunohistochemical technique (Tamimi et al 2008), and a therapeutic plan is formed based on each intrinsic subtype. Neoadjuvant chemotherapy (NAC) has been the standard treatment for locally-advanced breast cancer (Makhoul & Kiwan 2011). A NACrelated disadvantage is the delay of surgical treatment in patients who do not respond to chemotherapy. If we can predict the final chemotherapeutic response during earlier NAC courses, an earlier and optimized treatment regimen is possible, thereby improving patient prognosis (Chollet et al 2002; Montagna et al 2010)

Objectives

Methods

Results

Conclusion