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• Clinical Article •
Predicting the efficacy of neoadjuvant chemotherapy for breast cancer by combining hormone receptor and human epidermal growth factor receptor 2 with ADC maximum
LI Zhifan  LIU Xinran  WANG Ziyuan  FENG Wen  LEI Junqiang 

Cite this article as: LI Z F, LIU X R, WANG Z Y, et al. Predicting the efficacy of neoadjuvant chemotherapy for breast cancer by combining hormone receptor and human epidermal growth factor receptor 2 with ADC maximum[J]. Chin J Magn Reson Imaging, 2023, 14(10): 71-77. DOI:10.12015/issn.1674-8034.2023.10.013.


[Abstract] Objective To construct a nomogram based on MRI and clinicopathological indicators of breast cancer for early prediction of pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) in breast cancer patients.Materials and Methods A total of 82 breast cancer patients who underwent NAC and subsequent surgery at the First Hospital of Lanzhou University from January 2021 to October 2022 were retrospectively analyzed. Imaging and clinicopathological data of patients prior to NAC were collected. All patients underwent MRI scanning program before surgery. First, a univariate logistic regression analysis was performed to screen out the predictors associated with pCR. Multivariate logistic regression analysis was then performed to finally screen out the independent predictors of pCR. The independent predictors were used to construct a nomogram model for predicting pCR after NAC for breast cancer. Bootstrap was used for internal validation and calibration of models. The ROC curve was drawn to evaluate the diagnostic efficacy of the model, and the clinical application value of the model was evaluated by the decision curve analysis (DCA).Results This study showed that progesterone receptor (PR) state (P=0.04), human epidermal growth factor receptor 2 (HER-2) state (P＜0.01), and maximum apparent diffusion coefficient (ADCmax) (P=0.03) were independent predictors of pCR. The area under the ROC curve of the nomogram was 0.86. The calibration plot showed a high degree of agreement between the nomogram prediction probability and the actual pCR probability. Decision curve analysis showed that the nomogram model had good clinical application value. The corrected concordance index (C-index) for internal verification by the Bootstrap method was 0.84.Conclusions The nomogram model is helpful in predicting the pCR after NAC for breast cancer, which was constructed based on HER-2 status, PR status and ADCmax value, so as to realize personalized diagnosis and treatment of patients and improve their prognosis.
[Keywords] breast cancer；neoadjuvant chemotherapy；pathological complete response；nomogram；magnetic resonance imaging

LI Zhifan1   LIU Xinran1   WANG Ziyuan1   FENG Wen1   LEI Junqiang1, 2*  

1 The First Clinical Medical College, Lanzhou University, Lanzhou 730000, China

2 Department of Radiology, the First Hospital of Lanzhou University, Lanzhou 730000, China

Corresponding author: LEI J Q, E-mail: leijq2011@126.com

Conflicts of interest   None.

ACKNOWLEDGMENTS Gansu Province Education Science and Technology Innovation Project (No. 2022B-025).
Received  2023-06-19
Accepted  2023-09-14
DOI: 10.12015/issn.1674-8034.2023.10.013
Cite this article as: LI Z F, LIU X R, WANG Z Y, et al. Predicting the efficacy of neoadjuvant chemotherapy for breast cancer by combining hormone receptor and human epidermal growth factor receptor 2 with ADC maximum[J]. Chin J Magn Reson Imaging, 2023, 14(10): 71-77. DOI:10.12015/issn.1674-8034.2023.10.013.

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