Prognostic value of breast MRI characteristics before and during neoadjuvant endocrine therapy in patients with ER+/HER2- breast cancer
Ragusi, Max Aa; Winter-Warnars, Gonneke Ao; Wesseling, Jelle; Linn, Sabine C.; Beets-Tan, Regina G.; van der Velden, Bas Hm; Elias, Sjoerd G.; Gilhuijs, Kenneth Ga; Loo, Claudette E.
(2021) The British journal of radiology, volume 94, issue 1123, pp. 1 - 10
(Article)
Abstract
OBJECTIVE: To investigate whether BIRADS MRI characteristics before or during neoadjuvant endocrine therapy (NET) are associated with the preoperative endocrine prognostic index (PEPI) in ER+/HER2- breast cancer patients. METHODS: This retrospective observational cohort study included 35 ER+/HER2- patients with 38 tumors (3 bilateral cases) treated with NET. The pre- and
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midtreatment (after 3 months) MRIs were evaluated by two breast radiologists for BIRADS imaging characteristics, shrinkage pattern, and radiologic response. PEPI was used as end point. PEPI is based on the post-treatment surgical specimen's pT- and pN-stage, Ki67, and ER-status. Tumors were assigned PEPI-1 (good prognosis) or PEPI-2/3 (poor prognosis). We investigated whether pre- and midtreatment BIRADS characteristics were associated with PEPI. RESULTS: Median patient age was 65 years (interquartile interval [IQI]: 53, 70). 17 tumors (44.7%) were associated with good prognosis (PEPI-1), and 21 tumors (55.3%) with poor prognosis (PEPI-2/3). A larger reduction in tumor size after 3 months of NET was significantly associated with PEPI; 10 mm (IQI: 5, 13.5) in PEPI-1 tumors vs 4.5 mm (IQI: 3, 7; p = .045) in PEPI-2/3 tumors. Other BIRADS characteristics, shrinkage pattern or radiologic response were not associated with PEPI. CONCLUSION: Only a larger reduction in tumor size on MRI after 3 months of NET was associated with PEPI-1 (good prognosis) in ER+/HER2- breast cancer patients. ADVANCES IN KNOWLEDGE: MRI characteristics previously reported to be associated with prognosis during neoadjuvant chemotherapy are not necessarily associated with prognosis during NET in ER+/HER2- breast cancer patients.
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Keywords: Aged, Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Aromatase Inhibitors/administration & dosage, Biomarkers, Tumor/analysis, Breast Neoplasms/diagnostic imaging, Contrast Media, Female, Humans, Magnetic Resonance Imaging/methods, Middle Aged, Neoadjuvant Therapy, Neoplasm Staging, Prognosis, Receptor, ErbB-2/analysis, Receptors, Estrogen/analysis, Retrospective Studies, Tamoxifen/administration & dosage, Radiology Nuclear Medicine and imaging, Observational Study, Journal Article
ISSN: 1748-880X
Publisher: British Institute of Radiology
Note: Publisher Copyright: © 2021 The Authors. Published by the British Institute of Radiology under the terms of the Creative Commons Attribution-NonCommercial
(Peer reviewed)