Correlation Between MRI Signs And NAC Efficacy Before Neoadjuvant Chemotherapy In Breast Cancer

Objective To explore the value of analyzing the clinical and pathological information of BC patients and MRI features before chemotherapy in predicting breast tumor response after NAC.Methods A total of 105 patients with BC confirmed by needle biopsy in our hospital from January 2015 to September 2020 were retrospectively collected in strict accordance with the exclusion and inclusion criteria.The clinical,pathological and MRI information of pre-NAC BC patients were collected.The tumor size,shape,boundary,edge,intratumoral T2WI high signal intensity,periatumoral edema,anterior edema,subcutaneous edema,ADC value,enhancement mode,and time signal-curve were recorded in MRI images before treatment.After the end of NAC,BC patients were divided into PCR group and non-PCR group by surgical pathological results.Univariate analysis was performed for clinical,pathological and pre-NAC MRI features between the groups,and indicators with P<0.05 and possible clinical significance were further included in the multivariate analysis.In univariate analysis,the χ2 test was used for enumeral data,the Mann-Whitney U test was used for measurement data,and the binary Logistic regression analysis was used for multivariate analysis.Results Among 105 BC patients,22(21%)patients obtained pCR.1.Clinicopathological factors:The results of this study show that BC patients with menarche age≤13 years,HER-2 overexpression,PR expression negative,HER-2 expression positive,and Ki-67 expression≥30%have higher levels after NAC The difference in pCR rate was statistically significant.The P values were 0.045,0.047,0.005,0.006,0.011,and PR expression level<1%was an independent factor in the assessment of breast cancer NAC response.There were no statistically significant differences in the age of onset,number of births,menopause,T stage,N stage,NAC cycle,NAC protocol,histological grade,ER,AR,CK5/6 and EGFR expression levels of BC patients between the two groups.P values are all>0.05.2.Correlation between MRI features and NAC response before treatment:pre-NAC tumors appear on MRI as diameter≤3cm,round or oval,clear borders,smooth edges,and no high T2 in the tumor BC patients with signal,no chest edema,no subcutaneous edema,and uniform enhancement are more likely to obtain pCR after NAC.The difference is statistically significant.The P values are 0.003,0.001,0.000,0.000,0.001,0.000,0.025,0.000,and tumors Boundaries and enhancement methods are independent influencing factors for evaluating NAC response.However,other MRI features such as ADC value,TIC curve,and peritumoral edema were not statistically different between the two groups,and the P values were all>0.05.Conclusion Some MRI features and clinicopathological features of breast cancer before NAC are helpful for early clinical evaluation of the efficacy of NAC.