ArticleBreast cancer research : BCR2019
Radiologic complete response (rCR) in contrast-enhanced magnetic resonance imaging (CE-MRI) after neoadjuvant chemotherapy for early breast cancer predicts recurrence-free survival but not pathologic complete response (pCR).
Article in Breast cancer research : BCR, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 2 of them syntheses that pooled it.
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48 citing papers in PubMed, 2 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Value of shear wave elastography in evaluating response to neoadjuvant chemotherapy in breast cancer: A systematic review and meta-analysis.The Journal of international medical research · 2026Pooled it
- Imaging findings for response evaluation of ductal carcinoma in situ in breast cancer patients treated with neoadjuvant systemic therapy: a systematic review and meta-analysis.European radiology · 2023Pooled it
- MRI does not predict pathologic complete response after neoadjuvant chemotherapy for breast cancer.Journal of surgical oncology · 2019Trial
- Ability of MRI Breast to Predict Pathologic Complete Response Following Neoadjuvant Systemic Therapy in Patients with Breast Cancer.The Indian journal of radiology & imaging · 2026Review
- Ultrasound and Clinicopathological Features-Based Machine Learning Model for Predicting Neoadjuvant Therapy Efficacy in Breast Cancer.Cancer reports (Hoboken, N.J.) · 2026Article
- Modification of RECIST 1.1 criteria for assessing response in breast tumours treated with radiation therapy using multiparametric breast MRI: Radiology and oncology perspective.Breast (Edinburgh, Scotland) · 2026Article
- Article
- Primary tumour response on breast MRI as a predictor of axillary pathologic response in breast cancer patients treated with neoadjuvant chemotherapy.European radiology · 2026Article
- Research on Omitting Sentinel Lymph Node Biopsy after Neoadjuvant Therapy in cN1 Breast Cancer Patients.Cancer medicine · 2026Article
- Pre-Treatment Breast MRI Features and ADC Values as Predictors of Pathologic Complete Response in Breast Cancer: A Molecular Subtype-Based Analysis.Diagnostics (Basel, Switzerland) · 2026Article
- Prognostic value of molecular and radiologic characteristics on dedicated breast [EJNMMI research · 2025Article
- Early tumor volume reduction by breast DCE MRI predicts pathologic complete response to neoadjuvant therapy in triple negative breast cancer.NPJ breast cancer · 2025Article
- Prediction of Pathological Complete Response to Neoadjuvant Chemotherapy for Primary Breast Cancer Comparing Interim Shear Wave Elastography Versus Magnetic Resonance Imaging.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2025Observational
- Predicting Breast Cancer Pathologic Complete Response after Neoadjuvant Chemotherapy Using Bimodal US and MRI.Radiology. Imaging cancer · 2025Article
- Mammographic Calcifications Add Uncertainty in Predicting Response to Neoadjuvant Chemotherapy.Radiology · 2025Article
- Correlation Between Pathological and MRI Radiological Tumor Responses to Neoadjuvant Chemotherapy in Non-Luminal Breast Cancer: A Single Institution Experience.Cancer reports (Hoboken, N.J.) · 2025Article
- Clinical applications of next-generation sequencing-based ctDNA analyses in breast cancer: defining treatment targets and dynamic changes during disease progression.Molecular oncology · 2025Review
- Article
- MRI-Based Model for Personalizing Neoadjuvant Treatment in Breast Cancer.Tomography (Ann Arbor, Mich.) · 2025Article
- Ki-67 With MRI in Predicting the Complete Pathological Response Post-neoadjuvant Chemotherapy.Cureus · 2024Review
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17 authors at 3 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with early breast cancer (EBC) achieving pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) have a favorable prognosis. Breast surgery might be avoided in patients in whom the presence of residual tumor can be ruled out with high confidence. Here, we investigated the diagnostic accuracy of contrast-enhanced MRI (CE-MRI) in predicting pCR and long-term outcome after NACT.
methodsPatients with EBC, including patients with locally advanced disease, who had undergone CE-MRI after NACT, were retrospectively analyzed (n = 246). Three radiologists, blinded to clinicopathologic data, reevaluated all MRI scans regarding to the absence (radiologic complete remission; rCR) or presence (no-rCR) of residual contrast enhancement. Clinical and pathologic responses were compared categorically using Cohen's kappa statistic. The Kaplan-Meier method was used to estimate recurrence-free survival (RFS) and overall survival (OS).
resultsOverall rCR and pCR (no invasive tumor in the breast and axilla (ypT0/is N0)) rates were 45% (111/246) and 29% (71/246), respectively. Only 48% (53/111; 95% CI 38-57%) of rCR corresponded to a pCR (= positive predictive value - PPV). Conversely, in 87% (117/135; 95% CI 79-92%) of patients, residual tumor observed on MRI was pathologically confirmed (= negative predictive value - NPV). Sensitivity to detect a pCR was 75% (53/71; 95% CI 63-84%), while specificity to detect residual tumor and accuracy were 67% (117/175; 95% CI 59-74%) and 69% (170/246; 95% CI 63-75%), respectively. The PPV was significantly lower in hormone-receptor (HR)-positive compared to HR-negative tumors (17/52 = 33% vs. 36/59 = 61%; P = 0.004). The concordance between rCR and pCR was low (Cohen's kappa - 0.1), however in multivariate analysis both assessments were significantly associated with RFS (rCR P = 0.037; pCR P = 0.033) and OS (rCR P = 0.033; pCR P = 0.043).
conclusionPreoperative CE-MRI did not accurately predict pCR after NACT for EBC, especially not in HR-positive tumors. However, rCR was strongly associated with favorable RFS and OS.
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