Response predictivity to neoadjuvant therapies in breast cancer: A qualitative analysis of background parenchymal enhancement in CE-MRI.

Daniele La Forgia, Angela Vestito, Maurilia Lasciarrea, Maria Colomba Comes, Sergio Diotaiuti, Francesco Giotta, Agnese Latorre, Vito Lorusso, Raffaella Massafra, Gennaro Palmiotti, Lucia Rinaldi, Rahel Signorile, Gianluca Gatta, Annarita Fanizzi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: For assessing the predictability of oncology neoadjuvant therapy results, the background parenchymal enhancement (BPE) parameter in breast magnetic resonance imaging (MRI) has acquired increased interest. This work aims to qualitatively evaluate the BPE parameter as a potential predictive marker for neoadjuvant therapy. Method: Three radiologists examined, in triple-blind modality, the MRIs of 80 patients performed before the start of chemotherapy, after three months from the start of treatment, and after surgery. They identified the portion of fibroglandular tissue (FGT) and BPE of the contralateral breast to the tumor in the basal control pre-treatment (baseline). Results: We observed a reduction of BPE classes in serial MRI checks performed during neoadjuvant therapy, as compared to baseline pre-treatment conditions, in 61.3% of patients in the intermediate step, and in 86.7% of patients in the final step. BPE reduction was significantly associated with sequential anthracyclines/taxane administration in the first cycle of neoadjuvant therapy compared to anti-HER2 containing therapies. The therapy response was also significantly related to tumor size. There were no associations with menopausal status, fibroglandular tissue (FGT) amount, age, BPE baseline, BPE in intermediate, and in the final MRI step. Conclusions: The measured variability of this parameter during therapy could predict therapy effectiveness in early stages, improving decision-making in the perspective of personalized medicine. Our preliminary results suggest that BPE may represent a predictive factor in response to neoadjuvant therapy in breast cancer, warranting future investigations in conjunction with radiomics.

Original languageEnglish
Article number256
JournalJournal of Personalized Medicine
Volume11
Issue number4
DOIs
Publication statusPublished - Apr 1 2021

Keywords

  • Background parenchymal enhancement
  • Breast cancer
  • Breast MRI
  • Fibro glandular tissue
  • Neoadjuvant chemotherapy

ASJC Scopus subject areas

  • Medicine (miscellaneous)

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