LOCAL ADVANCED BREAST-CANCER - CONTRAST-ENHANCED SUBTRACTION MR-IMAGING OF RESPONSE TO PREOPERATIVE CHEMOTHERAPY

PURPOSE: To determine the value of contrast material-enhanced subtract ion magnetic resonance (MR) imaging in assessment of response to chemo therapy in locally advanced breast cancer. MATERIALS AND METHODS: Eigh teen women treated with chemotherapy because of locally advanced breas t cancer underwent preoperative MR examination including both routine and dynamic MR sequences after injection of gadolinium tetraazacyclodo decanetetraacetic acid. Any early contrast enhancement, concomitant wi th early vascular enhancement during the dynamic MR study, was conside red pathologic. RESULTS: Dynamic MR studies showed early contrast enha ncement in all women with residual tumor except one with nodular resid ual tumor. Histopathologic analysis and dynamic MR images of contrast- enhanced lesions correlated well, but in one patient, intraductal exte nsion was not seen on MR images, and in another, additional isolated t umor cells were seen in the histologic specimen. Subtraction images al ways facilitated visualization of vascular and pathologic contrast enh ancement. CONCLUSION: Dynamic MR contrast-enhanced subtraction studies are useful in assessment of residual tumor after chemotherapy.