Cancer du sein traité par chimiothérapie néoadjuvante : évaluation du reliquat tumoral par l'IRM mammaire. [MRI evaluation of residual breast carcinoma after neoadjuvant chemotherapy]

Anne Morvan 1, * Brigitte De Korvin 2 Catherine Bouriel 2 André Carsin 2 Patrick Tas 3 Claude Bendavid 4 Pierre-François Dupré 5 Pierre Kerbrat 6 Habiba Mesbah 7 Philippe Poree 7 Jean Levêque 4
* Auteur correspondant
1 Service de radiologie
2 Département d'imagerie
3 Anatomopathologie
4 Département de chirurgie
5 Département de Chirurgie gynécologique
6 Département d'oncologie médicale
7 Département d'informatique médicale
Abstract : PURPOSE: This study aims to evaluate the sensibility and specificity of MRI in the detection and size measuring of residual breast cancer in patients treated with neoadjuvant chemotherapy before surgery. PATIENTS AND METHODS: This is a retrospective study of 32 women, who underwent breast MRI before and after neoadjuvant treatment. MRI has been confronted to surgical pathology results. RESULTS: The sensibility of MRI to assess pathologic Complete Response (no invasive residual tumor) was excellent (100%) but the specificity was low (55,5%). There was no false negative case and four false positive cases (Two ductal carcinomas in situ and two scars-like fibrosis). When MRI outcomes were compared with the presence or absence of invasive or in situ residual carcinoma, only one false negative case was noticed (one "in situ" residual tumor). The correlation between tumor size measured by MRI and histopathology was low (r=0,32). Underestimations of tumor size were due to non-continuous tumor regression or invasive lobular carcinoma or association of invasive carcinoma and intra ductal breast cancer. Over estimations of tumor size were due to chemotherapy-induced changes. CONCLUSION: MRI is a sensitive but poorly specific method to assess the pathological complete response after neoadjuvant chemotherapy. Estimation of tumor size and detection of isolated residual in situ carcinoma are fare. Therefore, surgical intervention remains necessary whatever the MRI outcomes.
Type de document :
Article dans une revue
Journal de Radiologie, Elsevier Masson, 2010, 91 (6), pp.693-9
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http://www.hal.inserm.fr/inserm-00517363
Contributeur : Hervé De Villemeur <>
Soumis le : mardi 14 septembre 2010 - 13:49:40
Dernière modification le : mercredi 15 septembre 2010 - 11:31:09

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  • HAL Id : inserm-00517363, version 1
  • PUBMED : 20808270

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Anne Morvan, Brigitte De Korvin, Catherine Bouriel, André Carsin, Patrick Tas, et al.. Cancer du sein traité par chimiothérapie néoadjuvante : évaluation du reliquat tumoral par l'IRM mammaire. [MRI evaluation of residual breast carcinoma after neoadjuvant chemotherapy]. Journal de Radiologie, Elsevier Masson, 2010, 91 (6), pp.693-9. 〈inserm-00517363〉

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