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Constructing a MR-clinicopathological based nomogram to predict the shrinkage patterns of neoadjuvant therapy in breast cancer
LUO Yao  CAO Kun  LI Xiaoting  DENG Xubo  SUN Yingshi 

Cite this article as: LUO Y, CAO K, LI X T, et al. Constructing a MR-clinicopathological based nomogram to predict the shrinkage patterns of neoadjuvant therapy in breast cancer[J]. Chin J Magn Reson Imaging, 2024, 15(1): 35-42. DOI:10.12015/issn.1674-8034.2024.01.006.


[Abstract] Objective To select the baseline MRI features and clinicopathological factors that relate to tumor shrinkage patterns of breast cancers after neoadjuvant therapy (NAT), and construct a predicting nomogram.Materials and Methods A total of 272 consecutive patients with breast invasive ductal carcinoma who underwent NAT and surgical resection in our hospital were retrospectively analyzed. The patients were randomly divided into training group (190 cases) and validation group (82 cases). According to the morphological changes of tumor on MRI before and after NAT, the shrinkage patterns were divided into type I shrinkage (complete response, concentric shrinkage) and type Ⅱ shrinkage (non-concentric shrinkage, stable and progressing disease). Baseline MRI features (size, enhancement mode, semi-quantitative parameters of enhancement, etc.) together with clinical and pathological information (degree of differentiation, immunohistochemical molecular type, etc.) were collected. Univariate and multivariate logistic regression analysis were used to select effective factors and to establish the predictive models. The area under the curve (AUC) was used to evaluate the diagnostic performance of the model and select the best one to construct a nomogram.Results Type I and Ⅱ shrinkage pattern were seen in 174 (64.0%) and 98 (36.0%) patients respectively. Baseline MRI enhancement mode and hormone receptor (HR) were independently correlated with shrinkage types with AUCs of 0.844 [95% confidence intervals (CI): 0.784-0.892] and 0.593 (95% CI: 0.519-0.663) respectively in predicting type Ⅱ shrinkage. A combined predictive model was established with AUC of 0.890 (95% CI: 0.837-0.931), higher than that of any single parameter (P<0.05) with accuracy of 85.8%, and a nomogram was constructed. The AUC and accuracy for predicting type Ⅱ shrinkage in the validation group was 0.871 (95% CI: 0.779-0.935) and 82.9%.Conclusions Non single mass enhancement on MRI and positive HR are two independent risk factors for type Ⅱ shrinkage after NAT in breast cancer. A simple analysis of tumor enhancement mode and HR can provide a reasonable evaluation of the feasibility and effect of breast conservation after NAT.
[Keywords] breast cancer；neoadjuvant therapy；tumor shrinkage pattern；nomogram；magnetic resonance imaging

LUO Yao   CAO Kun   LI Xiaoting   DENG Xubo   SUN Yingshi*  

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiology, Peking University Cancer Hospital & Institute, Beijing 100142, China

Corresponding author: SUN Y S, E-mail: sys27@163.com

Conflicts of interest   None.

Received  2023-09-27
Accepted  2024-01-05
DOI: 10.12015/issn.1674-8034.2024.01.006
Cite this article as: LUO Y, CAO K, LI X T, et al. Constructing a MR-clinicopathological based nomogram to predict the shrinkage patterns of neoadjuvant therapy in breast cancer[J]. Chin J Magn Reson Imaging, 2024, 15(1): 35-42. DOI:10.12015/issn.1674-8034.2024.01.006.

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