Evaluation of neoadjuvant chemotherapy response with dynamic contrast enhanced breast MRI in locally advanced invasive breast cancer

PURPOSE: Determine the response of dynamic contrast enhanced breast MRI in locally advanced invasive breast cancer after neoadjuvant chemotherapy as compared with the gold standards of pathology.MATERIAL AND METHODS: Between January 2002 and October 2011, 38 patients who took neoadjuvant chemotheraphy for locally advanced invasive breast cancer were included our study. Only the patients who had all breast MRI before / after treatment took this study and who had surgery after treatment. Before and after neoadjuvant chemotherapy tumor measurement in mamografi, US, MRI were evaluated and compared with postoperative pathology results. Response rates were assesed with RECIST (Response Evolution Criteria in Solid Tumors) 1,1 criteria.MRI were done with 1,5 Tesla MR ( Gyroscan Achieva Intera, Philips ).Patients were given tacsan and antrasiclin groups for chemotherapy protocols, 4 + 4 cure. 7 patient took trastuzumab in addition tacsan and antrasiclin treatment.RESULTS: After neoadjuvant chemotherapy we found with MRI; % 13,2 complet response, % 73,7 partial response, %10,5 stabil disease, %2,6 progressive disease.After treatment pathologic response and MRI response correlated with kappa test (kappa: 0,63). Between pathologic response and mamografic response was low correlation with kappa test (kappa: 0,2). Between pathologic response and USG response was low correlation with kappa test (kappa: 0,2).CONCLUSIONS: Contrast enhanced dinamic breast MRI is more effective method than other radyologic methods in determine the response of neoadjuvant chemotherapy when compared pathologic data.Key words: NAC, Breast MRI, Locally advanced breast cancer.