Magnetic Resonance Imaging Enhancement Features Before and After Neoadjuvant Chemotherapy in Patients With Breast Cancer: A Predictive Value for Responders

Effect of Toremifene on Endometrium and Neurocognitive Function in Patients with Breast Cancer Based on Resting-State Functional Magnetic Resonance Imaging

In this study, the characteristics of hemodynamic changes with use of toremifene before and after neoadjuvant chemotherapy in breast cancer treatment were analyzed using resting-state functional magnetic resonance imaging. Also, the effect of toremifene on the quality of life of patients with advanced breast cancer was analyzed. The study population comprised 100 patients who received endocrine therapy after breast cancer surgery in our hospital from January 2016 to January 2019. Patients were randomly divided into an observation group and a control group, with 50 cases in each group. The observation group was treated with tamoxifen combined with toremifene treatment; the control group was treated with toremifene. Before and after chemotherapy, the same scheme was used to perform dynamic contrast-enhanced imaging of the breast using a 1.5T superconducting scanner with 3 mL/second bolus injection of adiphenine meglumine 0.2 mmol/kg. Semiquantitative blood flow measurement was completed on the workstation and before and after chemotherapy to compare results. The patient's quality of life, progesterone and estrogen levels, social function, physical function, mental function, and material function were analyzed. The mean values of the early enhancement parameters Efirst, Vfirst, Ee, and Ve before chemotherapy were greater than in the residual lesions after chemotherapy (P < 0.5). The semiquantitative study of resting brain function before and after breast cancer neoadjuvant chemotherapy showed that the hemodynamics of the residual lesions were significantly reduced, and the blood flow rate was significantly reduced. Compared with the clinical effect of tamoxifen in the treatment of breast cancer after surgery, tamoxifen combined with toremifene has more advantages in improving quality of life, improving progesterone levels, and reducing estrogen levels, and it has no detrimental effects on the endometrium.

Prediction of pathological complete response to neoadjuvant chemotherapy by magnetic resonance imaging in breast cancer patients

The purpose of this study was to evaluate whether the baseline breast MRI findings would be useful for the prediction for pathological complete response (pCR) by breast cancer patients to neoadjuvant chemotherapy. Primary breast cancer patients (stage II-III) preoperatively treated with sequential paclitaxel (12 cycles) and fluorouracil, epirubicin, and cyclophosphamide (4 cycles), followed by surgery were retrospectively enrolled, and 229 patients were eligible. Before chemotherapy, breast MRI studies were performed. Breast tumors were dichotomized into round + oval and irregular types based on MRI morphology. The round + oval tumors showed a significantly higher pCR rate than the irregular tumors (42.0% vs 17.3%; P < 0.001). In addition, PAM50 analysis revealed that basal and HER2-enriched tumors were significantly more prevalent among round + oval than irregular type tumors (P = 0.015). Baseline MRI morphology appears to be a significant predictor for pCR. The higher rate of the basal and HER2-enriched tumors among the round + oval tumors may explain their better chemo-sensitivity.

Evaluation of the treatment response to neoadjuvant chemotherapy in locally advanced breast cancer using combined magnetic resonance vascular maps and apparent diffusion coefficient

PURPOSE

To evaluate the treatment response of locally advanced breast cancer (LABC) to neoadjuvant chemotherapy using magnetic resonance (MR) vascular maps and apparent diffusion coefficient (ADC) at 3T. Materials and Methods Thirty-one patients with LABC who underwent breast MR studies before, after the first course, and after completing neoadjuvant chemotherapy were enrolled. Vascular morphology was retrieved via Hessian matrix and the voxels of the vessels and volume of vessels were measured automatically. Whole tumor mean ADC values were calculated. Clinical responders were defined as >50% tumor reduction in the final MR studies. Pathologically complete responders were also recorded.

RESULTS

There were 21 clinical responders and 10 nonresponders. Compared to the nonresponders after the first course, the responders were characterized by more vascular reduction of the breast lesion and decreased bilateral vascular discrepancy (voxels and volume), and increments in the ADC value and ADC percentage of the lesions (all P < 0.05). There were three pathological complete responders who showed more apparent early vascular reduction of the lesion breast (voxels and volume) and increments in the ADC value than others (P = 0.02, 0.01 and 0.02, respectively).

CONCLUSION

The early changes of MR vascular maps and ADC are associated with the final treatment response of LABC.