ABS ePoster Library

Introduction:
Magnetic resonance imaging (MRI ) has been used to evaluate the response to Neoadjuvant chemotherapy (NACT)and plan for surgery in Breast cancer treatment. For surgical planning, defining the extent of residual disease is the most important step. We reviewed our NACTdata including the overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI in predicting response.
Material and Method:
197 patients underwent NACT from January 2010 till August 2016. All patients had MRI before and at completion of NACT. Chemotherapeutic efficacy was analysed using international response evaluation criteria for solid tumours (RECIST). Correlation of pathological response on surgical specimen with response on MRI was evaluated. We analysed the overall sensitivity, specificity, positive predictive value and negative predictive value of MRI. Complete radiological response ( iCR) was defined as no detectable tumour on all serial images of MRI. Non ICR included partial response, stable disease and progressive disease.
Results:
Of 197 patients, 64 and 46 had iCR and pCR respectively. 133 patients had non iCR and 151 patients had non pCR. There was 65% concordance between MRI and final pathology in assessing complete response. The overall sensitivity, specificity, and accuracy were 58%, 53%, and 54% respectively. On the other hand the positive predictive value, negative predictive values were 32% and 76.6% respectively.
Conclusions:
MRI is a good tool in predicting complete pathological response post neoadjuvant chemotherapy in breast cancer. Our study showed a high negative predictive value of MRI scan in evaluating a non-response to chemotherapy.