Assessment of response to preoperative chemotherapy in patients with stage II and III breast cancer: the value of MRI

The response to preoperative chemotherapy in breast cancer was assessed by magnetic resonance imaging (MRI), and compared to the histological and clinical findings. Forty-two patients with stage II and III breast carcinoma were evaluated prospectively prior to and after preoperative chemotherapy by MRI, clinical and histological examination. Radiological response was assessed using the MRI parameters: total tumor volume (TTV), maximum enhancement index (MEI) and their product (TTV*MEI). A significant reduction in all MRI parameters was observed after chemotherapy. Overall clinical and radiological response rates were comparable (69% vs 73%). MRI was not useful for the prediction of complete pathologic response. A fair correlation between TTV postchemotherapy and final histological diameter was found. A significant difference of residual TTV for patients undergoing breast conservative surgery vs mastectomy was observed.