Decrease in breast density in the contralateral normal breast of patients receiving neoadjuvant chemotherapy: MR imaging evaluation - PubMed (original) (raw)

Decrease in breast density in the contralateral normal breast of patients receiving neoadjuvant chemotherapy: MR imaging evaluation

Jeon-Hor Chen et al. Radiology. 2010 Apr.

Abstract

Purpose: To investigate the change of breast density with quantitative magnetic resonance (MR) imaging in the contralateral normal breast of patients receiving neoadjuvant chemotherapy.

Materials and methods: This study was approved by the institutional review board and was HIPAA compliant. Informed consent was obtained. Fifty-four patients with breast cancer (mean age, 47 years; age range, 30-74 years) treated with NAC protocol and enrolled in a breast MR imaging research study were studied. The density in the contralateral normal breast was analyzed by using an MR imaging-based segmentation method. The effect of chemotherapy on the change of density following the doxorubicin and cyclophosphamide (AC) and the AC and taxane regimen was evaluated. The dependence on age was investigated by using a multivariate regression model.

Results: In patients who underwent both AC and taxane follow-up, the mean percentage of change from the individual's baseline density was -10% (95% confidence interval: -12.8%, -7.2%) after AC and -12.7% (95% confidence interval: -16%, -9.4%) after AC and taxane. In patients who underwent both follow-up studies after one to two and four cycles of AC, the mean percentage of change was -9.4% (95% confidence interval: -13.5%, -5.3%) after one to two cycles of AC and -14.7% (95% confidence interval: -20.6%, -8.7%) after four cycles of AC. The percentage reduction of density was significantly dependent on age. Patients younger than 40 years had a greater reduction after chemotherapy than patients older than 55 years (P = .01).

Conclusion: By using three-dimensional MR imaging, patients receiving chemotherapy showed reduction of breast density, and the effects were significant after initial treatment with one to two cycles of the AC regimen.

RSNA, 2010

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Figures

Figure 1a:

(a) Graph shows relationship between baseline (B/L) MR imaging percentage of density and age. Patients who underwent one-to-two AC-cycle follow-up MR imaging were analyzed. A linear regression fitting indicates a significant correlation with age (r = −0.4, P = .004). Fitting by using other nonlinear regression models also suggests a significant negative correlation. (b) Graph shows percentage of change normalized to the baseline density is significantly dependent on age (P = .01, multivariate regression analysis). All 11 patients younger than 40 years showed decreased density. Of the seven postmenopausal patients older than 55 years, four patients showed increased density and three showed decreased density. The difference was significant when compared by using the Fisher exact test (P = .01).

Figure 1b:

Figure 2a:

MR images in 41-year-old woman with invasive ductal cancer in the left breast. Images from the normal right breast obtained at (a) baseline MR imaging, (b) after two cycles of AC, (c) after two cycles of AC plus one cycle of taxane, and (d) the last MR imaging after two cycles of AC and three cycles of taxane. The density reduction at all follow-up MR imaging can be noted visually. The percentage reduction compared with the baseline density is 31% after two cycles of AC, 35% after two cycles of AC and one cycle of taxane, and 39% after completing the NAC treatment.

Figure 2b:

Figure 2c:

Figure 2d:

References

1. Kuerer HM, Newman LA, Smith TL, et al. Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. J Clin Oncol 1999;17(2):460–469 -PubMed
1. Fisher B, Bryant J, Wolmark N, et al. Effect of preoperative chemotherapy on the outcome of women with operable breast cancer. J Clin Oncol 1998;16(8):2672–2685 -PubMed
1. Bonadonna G, Valagussa P, Brambilla C, et al. Primary chemotherapy in operable breast cancer: eight-year experience at the Milan Cancer Institute. J Clin Oncol 1998;16(1):93–100 -PubMed
1. Booser DJ, Hortobagyi GN. Treatment of locally advanced breast cancer. Semin Oncol 1992;19(3):278–285 -PubMed
1. Singletary S, McNeese M, Hortobagyi GN. Feasibility of breast-conservation chemotherapy for locally advanced breast carcinoma. Cancer 1992;69(11):2849–2852 -PubMed

Decrease in breast density in the contralateral normal breast of patients receiving neoadjuvant chemotherapy: MR imaging evaluation - PubMed (original) (raw)