Contrast enhanced magnetic resonance imaging underestimates residual disease following neoadjuvant docetaxel based chemotherapy for breast cancer

Eur J Surg Oncol. 2004 Dec;30(10):1069-76. doi: 10.1016/j.ejso.2004.07.024.


Aims: We prospectively compared the ability of magnetic resonance imaging (MRI) to measure residual breast cancer in patients treated with different neoadjuvant chemotherapy regimen.

Methods: Forty patients with locally advanced breast carcinoma underwent neoadjuvant chemotherapy. Twelve patients received 5-fluoro-uracyl-epirubicin-cyclophosphamide (FEC-group, six cycles), 28 (DXL-group) received docetaxel-based chemotherapy (six cycles DXL-epirubicin: 13 patients, eight cycles DXL alone: 15 patients). All patients had baseline and preoperative MRI. The spread of pathologic residual disease (PRd) was compared to preoperative MRI measures according to chemotherapy regimen.

Results: MRI over/underestimation of the spread of residual tumour was never superior to 15mm in FEC group, whereas it appeared in 11/28 (39%, 30-48%-95% CI) patients in DXL group (p=0.017). Tumour shrinkage led to single nodular residual lesions in FEC group, whereas vast numerous microscopic nests were observed in docetaxel group in pathology.

Conclusion: Among tumours treated with a taxane-containing regimen, residual disease was frequently underestimated by MRI because of PRd features.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Antibiotics, Antineoplastic / administration & dosage
  • Antimetabolites, Antineoplastic / administration & dosage
  • Antineoplastic Agents, Alkylating / administration & dosage
  • Antineoplastic Agents, Phytogenic / administration & dosage*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Carcinoma / drug therapy
  • Carcinoma / pathology
  • Contrast Media*
  • Cyclophosphamide / administration & dosage
  • Docetaxel
  • Epirubicin / administration & dosage
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Magnetic Resonance Imaging*
  • Mastectomy
  • Mastectomy, Segmental
  • Middle Aged
  • Neoadjuvant Therapy*
  • Neoplasm, Residual
  • Prospective Studies
  • Taxoids / administration & dosage*


  • Antibiotics, Antineoplastic
  • Antimetabolites, Antineoplastic
  • Antineoplastic Agents, Alkylating
  • Antineoplastic Agents, Phytogenic
  • Contrast Media
  • Taxoids
  • Docetaxel
  • Epirubicin
  • Cyclophosphamide
  • Fluorouracil