Abstract
Breast background parenchymal enhancement (BPE) is an increasingly studied MRI parameter that reflects the microvasculature of normal breast tissue, which has been shown to change during neoadjuvant chemotherapy (NAC) for breast cancer. We aimed at evaluating the BPE in patients undergoing NAC and its prognostic value to predict recurrence. MRI BPE was visually and quantitatively evaluated before and after NAC in a retrospective cohort of 102 women with unilateral biopsy-proven invasive breast cancer. Pre-therapeutic BPE was not predictive of pathological response or recurrence. Quantitative post-therapeutic BPE was significantly decreased compared to pre-therapeutic value. Post-therapeutic quantitative BPE significantly predicted recurrence (HR = 6.38 (0.71, 12.06), p < 0.05).
Highlights
Breast background parenchymal enhancement (BPE) is an increasingly studied MRI parameter that reflects the microvasculature of normal breast tissue, which has been shown to change during neoadjuvant chemotherapy (NAC) for breast cancer
Tumor response after NAC is assessed pathologically[2], but imaging biomarkers based on breast dynamic-contrast enhanced MRI (DCE-MRI), such as the size of residual enhancing tumor after NAC, have shown very promising leads for non-invasive monitoring of NAC efficacy and prediction of long-term prognosis[3,4,5]
We studied the ability of post-chemotherapy BPE to predict the risk of recurrence
Summary
Breast background parenchymal enhancement (BPE) is an increasingly studied MRI parameter that reflects the microvasculature of normal breast tissue, which has been shown to change during neoadjuvant chemotherapy (NAC) for breast cancer. MRI BPE was visually and quantitatively evaluated before and after NAC in a retrospective cohort of 102 women with unilateral biopsy-proven invasive breast cancer. Pre-therapeutic BPE was not predictive of pathological response or recurrence. Post-therapeutic quantitative BPE significantly predicted recurrence (HR = 6.38 (0.71, 12.06), p < 0.05). Tumor response after NAC is assessed pathologically[2], but imaging biomarkers based on breast dynamic-contrast enhanced MRI (DCE-MRI), such as the size of residual enhancing tumor after NAC, have shown very promising leads for non-invasive monitoring of NAC efficacy and prediction of long-term prognosis[3,4,5]. The biological determinants of BPE are poorly known, except for its hormonal dependence, that accounts for the high variability of BPE in premenopausal women[10]
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