新辅助化疗后同心性收缩乳腺癌,预后更好
  • 磁共振成像显示肿瘤收缩模式分为同心收缩(CS)和非CS两种类型;
  • 183名低分化管腔型乳腺癌患者接受新辅助化疗(NAC),中位观察期为67.9个月,31例复发,16例死于乳腺癌,无病生存率(DFS)和总生存率(OS)均与肿瘤缩小模式有显著性差异;
  • 121例低分化管腔型乳腺癌患者接受NAC,中位随访期为56.9个月,20 (16.5%)例复发,8例 (6.6%) 死于乳腺癌,CS模式患者DFS明显更长,且预后良好;
  • 多元分析均显示,CS模式显著独立关联DFS和OS。
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Radiology [IF:7.931]

Pattern of Tumor Shrinkage during Neoadjuvant Chemotherapy Is Associated with Prognosis in Low-Grade Luminal Early Breast Cancer

低分化早期管腔型乳腺癌新辅助化疗中肿瘤缩小模式与预后相关

10.1148/radiol.2017161548

2017-07-24, Article

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Purpose To evaluate the association between tumor shrinkage patterns shown with magnetic resonance (MR) imaging during neoadjuvant chemotherapy (NAC) and prognosis in patients with low-grade luminal breast cancer. Materials and Methods This retrospective study was approved by the institutional review board and informed consent was obtained from all subjects. The low-grade luminal breast cancer was defined as hormone receptor-positive and human epidermal growth factor receptor 2-negative with nuclear grades 1 or 2. The patterns of tumor shrinkage as revealed at MR imaging were categorized into two types: concentric shrinkage (CS) and non-CS. Among 854 patients who had received NAC in a single institution from January 2000 to December 2009, 183 patients with low-grade luminal breast cancer were retrospectively evaluated for the development set. Another data set from 292 patients who had received NAC in the same institution between January 2010 and December 2012 was used for the validation set. Among these 292 patients, 121 patients with low-grade luminal breast cancer were retrospectively evaluated. Results In the development set, the median observation period was 67.9 months. Recurrence was observed in 31 patients, and 16 deaths were related to breast cancer. There were statistically significant differences in both the disease-free survival (DFS) and overall survival (OS) rates between patterns of tumor shrinkage (P < .001 and P < .001, respectively). Multivariate analysis demonstrated that the CS pattern had the only significant independent association with DFS (P = .001) and OS (P = .009) rate. In the validation set, the median follow-up period was 56.9 months. Recurrence was observed in 20 patients (16.5%) and eight (6.6%) deaths were related to breast cancer. DFS rate was significantly longer in patients with the CS pattern (72.8 months; 95% confidence interval [CI]: 69.9, 75.6 months) than in those with the non-CS pattern (56.0 months; 95% CI: 49.1, 62.9 months; P ≤ .001). The CS pattern was associated with an excellent prognosis (median OS, 80.6 months; 95% CI: 79.3, 81.8 months vs 65.0 months; 95% CI: 60.1, 69.8 months; P = .004). Multivariate analysis demonstrated that the CS pattern had the only significant independent association with DFS (P = .007) and OS (P = .037) rates. Conclusion The CS pattern as revealed at MR imaging during NAC had the only significant independent association with prognosis in patients with low-grade luminal breast cancer. (©) RSNA, 2017.

First Authors:
Ippei Fukada

Correspondence Authors:
Yoshinori Ito

All Authors:
Ippei Fukada,Kazuhiro Araki,Kokoro Kobayashi,Tomoko Shibayama,Shunji Takahashi,Naoya Gomi,Yumi Kokubu,Katsunori Oikado,Rie Horii,Futoshi Akiyama,Takuji Iwase,Shinji Ohno,Kiyohiko Hatake,Naohiro Sata,Yoshinori Ito

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