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False-positive MRI Findings in Breast Cancer After Neoadjuvant Chemotherapy and Correlation Between Tumor Response Patterns and HER2 Status
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Original Article
VOLUME: 56 ISSUE: 2
P: 97-105
2023

False-positive MRI Findings in Breast Cancer After Neoadjuvant Chemotherapy and Correlation Between Tumor Response Patterns and HER2 Status

Acta Haematol Oncol Turc 2023;56(2):97-105
DOI: 10.5505/aot.2023.60973
Aydan Avdan Aslan 1
Servet Erdemli 2
İbrahim Halil Erdoğdu 3
Serap Gültekin 1
Cihan Uras 4
Fatma Tokat 5
Ali Arıcan 6
Leyla Özer 6
Kemal Behzatoğlu 5
Nezih Meydan 7
Füsun Taşkın 2
1. Department Of Radiology, Gazi University, Ankara, Turkey.
2. Department Of Radiology, Acibadem M.A.A. University, İstanbul, Turkey.
3. Department Of Pathology, Adnan Menderes University School Of Medicine, Aydın, Turkey
4. Department Of General Surgery, Acibadem M.A.A. University, Istanbul, Turkey
5. Department Of Pathology, Acibadem M.A.A. University, Istanbul, Turkey
6. Department Of Medical Oncology, Acibadem M.A.A. University, Istanbul, Turkey
7. Department Of Medical Oncology, Adnan Menderes University, Aydın, Turkey
8.
No information available.
No information available
Received Date: 2022-11-13T23:50:16
Accepted Date: 2023-08-07T09:01:48
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Abstract

INTRODUCTION

To demonstrate false-positive MRI findings after neoadjuvant chemotherapy (NAC) in patients with pathologic complete response (pCR) and investigate the correlation between post-NAC MRI findings and tumor response patterns based on human epidermal growth factor receptor 2 (HER2) status.

METHODS

This retrospective multicenter study enrolled 118 patients with breast cancer who received NAC and achieved pCR. Tumors were evaluated with MRI pre- and post-NAC. MRI evaluation included lesion characteristics, kinetic curve analysis, background parenchymal enhancement (BPE), and post-NAC changes of MRI features. Tumor response patterns were also assessed and categorized based on MRI findings. Tumor response patterns and post-NAC MRI findings were correlated with HER2 status.

RESULTS

The residual MRI findings following NAC differed significantly between HER2+ and HER2− groups (p=0.02). The most frequent false-positive MRI finding was focus and foci in HER2+ tumors, whereas non-mass enhancement (NME) in HER2− group. The presence of ductal carcinoma in situ (DCIS) and fibrosis in surgical pathology is significantly associated with NME on post-NAC MRI (p<0.001). Axillary pCR was achieved significantly higher in the HER2+ group (p=0.04).

DISCUSSION AND CONCLUSION

Although MRI is considered the most reliable method for evaluating tumor response after NAC, over and underestimation is still possible. This study revealed that tumor response patterns and post-NAC MRI findings differ according to HER2 status. The diagnostic accuracy of post-NAC MRI is evolving by understanding the underlying mechanisms and tumor biology.