The Effect Of Dynamic-Enhanced Magnetic Resonance Imaging Associated With Diffusion-Weighted Imaging On The Preoperative Evaluation In Breast Cancer Patients Treated With Neoadjuvant Chemotherapy

Objective:To evlauate the effect of dynamic-enhanced magnetic resonance imaging associated with diffusion-weighted imaging on the preoperative evaluation in brest cancer patients treated with neoadjuvant chemotherapy(NAC).Matierials and Methods:30 patients with breast cancer who were diagnosed by Bard magnum biopsy needles,and with clinical stagesⅡA-ⅢC were enrolled in this study,2-5 cycles of NAC(including the paclitaxel or adriamycin or combination of the two)was given to all the patients,all of them were performed magnetic resonances imaging(MRI), B-ultrasounds and clinical examination.Regarding the pathological results as the gold standard,the longest diameter and the shortest diameter which were measured by clinical examinations,ultrasonography, and MRI were compared with the pathological results respectively,then evaluate the effect of MRI on the accuracy for MRI on the evaluation of the size and patterns of residual tumor.And meanwhile evaluated the roles of MRI in evaluating whether or not axillary nodes were metastatic.Results:A strongest correlation between the longest diameter measured by MRI and pathology(r=0.840,p＜0.005),a moderate correlation between ultrasonography and pathology(r=0.635,p＜0.005), and a moderate correlation between clinical examination and pathology (r=0.583,p＜0.005)were observed,Respectively.Essentially the same results were obtained for the shortest diameter(i.e,the strongest correlation was observed between MRI and pathology).Residual tumors after NAC present two patterns:20%with multifocal or dendritic patterns which often belong to the kinds of diffuse diminution and 80%with single nodulous patterns which the kinds of centripetal diminution.The sensitivity,specificity and accuracy rating for the judgement of the MRI on the metastasis of axillary nodes were 45.5%,50.0%and 46.7%, respectively;And the clinical examination's were 27.3%,87.5%and 43.3%.According to the final results of dynamic-enhanced magnetic resonance imaging associated with diffusion-weighted imaging,five patients changed their original operation plans.Conclusions:Dynamic-enhanced magnetic resonance imaging associated with diffusion-weighted imaging MRI was better than conventional methods for the evaluation of residual tumor extent and morphous of patients after NAC,thus could help surgeons carrying out better preoperative evaluations,and selecting better operative plans and surgical margins.