The Role of Magnetic Resonance Imaging in Predicting Pathological Complete Response in Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Objective: Neoadjuvant chemotherapy (NACT) has been used more frequently in the treatment of non-metastatic breast cancer.Achieving a pathological complete response (pCR) after NACT provides us with information about the prognosis of the disease.We aimed to investigate the diagnostic accuracy of preoperative magnetic resonance imaging (MRI) in predicting pCR in patients with breast cancer. Method:The charts of patients who received NACT for breast cancer between 2018 and 2024 were retrospectively analyzed.Factors associated with radiologic complete response (rCR) and pCR were analyzed in univariate and multivariate settings.The correlation between rCR and pCR according to MRI interpretation was analyzed.Results: A total of 153 patients were included in this study; 26 (17%) of these patients achieved rCR, and 39 (25.5%) achieved pCR.A statistically significant correlation was found between pCR and rCR assessed on MRI.Sensitivity, specificity, accuracy, pCR predictive value (PPV) and non-pCR predictive value were estimated at 51.3%, 94.7%, 83.7%, 76.9% and 85%, respectively.Statistically significant correlations between rCR and pCR were found in Luminal A (p<0.05), Luminal B (p<0.05), HER2positive (p<0.05), but not in triple negative subtypes (p>0.05).In univariate and multivariate analysis, tumor characteristics significantly associated with both rCR and pCR were tumor size, lymph node metastasis and molecular subtypes.Ama: Neoadjuvan kemoterapi (NACT), metastatik olmayan meme kanserinin tedavisinde daha sk kullanlmaktadr.NACT sonrasnda patolojik tam yant (pCR) elde etmek, bize hastaln prognozu hakknda bilgi salar.Meme kanseri hastalarnda pCR'yi tahmin etmede preoperatif manyetik rezonans grntlemenin (MRI) tansal doruluunu aratrmay amaladk.Yntem: 2018-2024 yllar arasnda meme kanseri nedeniyle NACT alan hastalarn izelgeleri retrospektif olarak analiz edildi.Radyolojik tam yant (rCR) ve pCR ile ilikili faktrler tek deikenli ve ok deikenli ortamlarda analiz edildi.MRI yorumlamasna gre rCR ve pCR arasndaki korelasyon analiz edildi.Bulgular: Bu almaya toplam 153 hasta dahil edildi; bu hastalarn 26's (%17) rCR'ye ularken, 39'u (%25,5) pCR'ye ulat.pCR ve MRI'da deerlendirilen rCR arasnda istatistiksel olarak anlaml bir korelasyon bulundu.Duyarllk, zgllk, doruluk, pCR ngr deeri (PPV) ve pCR d ngr