Neoadjuvant chemotherapy (NAC) is commonly used to treat breast cancer patients, particularly those patients with early triple negative, human epidermal growth factor-2, local advanced, and inflammatory breast cancers. The advantage of neoadjuvant chemotherapy is to decrease the size of the tumor to facilitate breast conservation for some inoperable tumors, evaluate “in vivo” treatment response, and to presumptively predict prognosis based on the ability of the chemotherapeutic regimen to produce complete pathologic response. Breast MRI is the most accurate imaging modality to evaluate treatment response to NAC. The course will describe how consistency is critical when reporting pre-and post- NAC MRI findings. It will review the different patterns of responses of breast cancers to NAC, including overestimation and underestimation of treatment response. Cases with complete, partial, and non-response to treatment on breast MRI will be shown.
Learning Objectives:
Recognize the importance of consistency when reporting findings on MRI for evaluation of treatment response to neoadjuvant chemotherapy (NAC).
Recognize the patterns of response of breast cancers undergoing NAC.
Discuss the potential pitfalls that can produce over- or underestimation of disease on breast MRI performed for assesment of treatment response.
