Correlation Analysis Of Breast MRI And Pathological MP Grading In Clinical Application Of Neoadjuvant Chemotherapy Effective Evaluation For Breast Cancer

BackgroundBreast cancer is the most common female malignancy in China and the world,and it shows a younger trend.With the development of medical technology,chemotherapy has become one of the main treatment methods for breast cancer.Neoadjuvant chemotherapy（NAC）,also known as preoperative chemotherapy,refers to the application of chemotherapy drugs before surgery,and the main objectives include downgrading inoperable breast cancer to operable breast cancer,downgrading non-breast-conserving breast cancer to breast-conserving breast cancer,and obtaining information on drug sensitivity in vivo to guide subsequent treatment to improve patient overall suvivial and Which indicate it is beneficial to locally advanced breast cancer.Studies have shown that patients who achieve pathological complete response（p CR）after NAC have a good prognosis,and the p CR rate is gradually increasing with the advent of new chemotherapy regimens and chemotherapeutic agents.For patients with NAC.Imaging evaluation is a basis for surgical treatment due to efficacy of chemotherapy and accurate judgment of tumor residue.At present,compared with MRI,as an accurate evaluation during NAC,MP in pathology is still a gold standard guideline.In clinical work,we can observe the difference between the results of MRI evaluation and pathological evaluation,exploringthe prediction of prognosis is mandatory for the doctors to know the following treatment.Therefore,this study collected breast cancer patients who underwent breast MRI before and after NAC,and analyzed the related factors of different breast cancer patients with MRI and pathological MP grading to evaluate NAC efficacy,so as to provide clinical guidance for accurately predicting the prognosis of patients.ObjectiveTo explore the reasons for the difference between breast MRI and pathological MP grade in evaluating the efficacy of neoadjuvant chemotherapy for breast cancer,and to discover the impact factors between the difference and molecular typing,so as to provide reference for clinical application.Methods96 female patients who were diagnosed unilateral breast cancer by core needle biopsy before NAC and post-NAC surgery,and underwent breast MRI examination before and after NAC treatment were collected from the Breast Surgery Department of the Second Hospital of Jilin University from June 2019 to January 2022.We collected the information including age,initial tumor size,lymph node status,histological grade and molecular classification,estrogen receptor（ER）and progesterone receptor（PR）,cell proliferating nuclear antigen（Ki-67）and human epidermal growth factor（HER-2）expression of the state,number of lesions,histological type and examination（MRI）images and findings of the complete imaging cycle.According to the results of surgical pathological examination after NAC,the patients were divided into pathological marked group（grade 4-5）and non-marked group（grade 1-3）.Meanwhile,the patients were divided into clinically significant relief group（CR+ PR）and non-significant remission group（SD）according to the RECIST evaluation criteria.We try to find the difference between MRI and MP.Univariate and binary logistic regression were used to analyze the influencing factors of the difference between MRI and pathological MP grading in evaluating NAC efficacy,and further stratified analysis was carried out according to molecular subtype.Results1.After NAC,MRI was used to evaluate the curative effect.There were 77 cases in the clinically marked and 19 cases in the non-effective group.It was confirmed by surgery and pathology that there were 4 4cases in the pathologically effective group and 52 cases in the non-effective group.MRI and pathological MP grading were used to evaluate the consistency of the efficacy of NAC.The difference was statistically significant（p<0.05）.2.Univariate analysis showed that molecular type,the enhancement mode of tumor on MRI,molecular classification,histological grade and the number of tumor were affecting the consistency of MRI and pathological MP grading in evaluating the efficacy of NAC（p<0.05）.3.Multivariate Logistic regression analysis showed that only molecular subtype was an independent influencing factor for the consistency of MRI and pathological MP grading in evaluating the efficacy of NAC.4.Among different molecular classifications,when the histological grade was grade III and mass-like enhancement on MRI,there was no significant difference between MRI and pathological MP grading in evaluating NAC efficacy（p>0.05）,and the consistent rate of efficacy evaluation of HER-2 positive and triple-negative type was significantly higher than that of Luminal subtype（p<0.05）.Conclusion1.Breast MRI and pathological MP grading have differences in the consistency of evaluation results when evaluating the efficacy of NAC.2.The difference of breast MRI and pathological MP grading in evaluating the efficacy of NAC is related to molecular type,histological type,enhancement mode of cancer on MRI,histological grade and the number of lesions.3.Breast MRI can accurately evaluate the NAC efficacy of the tumor as histological grade III and tumor MRI mass-like enhancement.4.Breast MRI and pathological MP grading were used to evaluate the efficacy of NAC,and the consistency of triple-negative and HER-2positive type was high.