Magnetic resonance imaging is more accurate than mammography for assessing response to neoadjuvant chemotherapy in a breast cancer patient with significant calcifications

Sam C Wang¹, Bonnie N Joe², Laura J Esserman¹

¹Carol Franc Buck Breast Care Center, Department of Surgery, University of California, San Francisco, San Francisco, CA, USA; ²Department of Radiology, University of California San Francisco, San Francisco, CA, USA

Abstract: For patients with operable breast cancer, neoadjuvant chemotherapy can increase the chance for breast-conserving resection without sacrificing survival length. Breast imaging is an important tool for following disease progression in patients undergoing preoperative therapy. We present a patient who had significant calcification associated with her primary tumor and axillary lymph node disease. After undergoing a course of chemotherapy that was truncated due to side effects, mammogram showed these deposits remained unchanged even though magnetic resonance imaging (MRI) demonstrated that she had a complete response at both sites. Indeed on final pathologic examination there was no invasive disease remaining in the breast and axillary lymph nodes. This case shows the potential superiority of MRI relative to mammograms in assessing the therapeutic response of breast cancer associated with calcifications after neoadjuvant chemotherapy.

Keywords: breast cancer, calcifications, neoadjuvant chemotherapy, magnetic resonance imaging