Breast Cancer Molecular Phenotype and the Use of HER2-Targeted Agents Influence the Accuracy of Breast MRI After Neoadjuvant Chemotherapy
Breast Cancer Molecular Phenotype and the Use of HER2-Targeted Agents Influence the Accuracy of Breast MRI After Neoadjuvant Chemotherapy
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DOI：
10.1097/sla.0b013e3182686bd9
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发表时间：
2013-01-01
影响因子：
9
通讯作者：
Noh, Dong-Young
中科院分区：
文献类型：
--
作者：
Moon, Hyeong-Gon;Han, Wonshik;Noh, Dong-Young
目的：研究新辅助系统治疗（NST）后磁共振成像（MRI）的准确性是否受原发性乳腺癌的分子特征和人表皮生长因子受体2（HER2）靶向药物的使用的影响。背景：提高对NST后影响乳腺MRI准确性的因素的理解，可以更有针对性地使用MRI来决定NST后的手术范围。我们分析了463例接受NST的患者的影像学和临床病理资料。我们的目的是研究分子亚型和靶向治疗的使用是否与MRI预测残留肿瘤范围的准确性变化相关。结果如下：MRI预测残留肿瘤范围的准确性在三阴性乳腺癌中最准确，在Luminal A亚型中最不准确（Pearson相关系数分别为0.754和0.531）。多因素分析提示雌激素受体（ER）状态是影响MRI准确性的独立因素。在HER2扩增的肿瘤，使用HER2靶向药物与一个不太准确的MRI prediction.Conclusions：MRI在预测残留肿瘤范围的准确性是最低的ER阳性肿瘤与NST治疗。在HER2阳性肿瘤中，NST后使用HER2靶向药物导致MRI准确度降低。在决定新辅助化疗后保乳的程度时应考虑这些因素。
Objective: To investigate whether the accuracy of magnetic resonance imaging (MRI) after neoadjuvant systemic therapy (NST) is affected by molecular features of primary breast cancer and the use of human epidermal growth factor receptor 2 (HER2)-targeted agents.Background: Improved understanding of factors affecting the accuracy of breast MRI after NST can lead to more tailored use of MRI in deciding surgical extent after NST.Methods: We analyzed the imaging and clinicopathological data of 463 patients who underwent NST. We aimed to investigate whether the molecular subtypes, and the use of targeted therapies, were associated with changes in the accuracy of MRI predicting residual tumor extent. Results: The accuracy of MRI predicting the residual tumor extent was most accurate in triple-negative breast cancer and was least accurate in Luminal A subtype (Pearson correlation coefficient of 0.754 and 0.531, respectively). Multivariate analysis suggested estrogen receptor (ER) status as an independent factor influencing the MRI accuracy. In HER2-amplified tumors, the use of HER2-targeted agents was associated with a less accurate MRI prediction.Conclusions: The accuracy of MRI in predicting residual tumor extent was lowest in ER-positive tumors treated with NST. In HER2-positive tumors, the use of HER2-targeted agents resulted in a less accurate MRI after NST. These factors should be considered for deciding the extent of breast conservation after neoadjuvant chemotherapy.