MR Elastography Predicts Breast Cancer Treatment Response and Survival

In a recent prospective longitudinal study, researchers investigated the use of MR elastography to predict response to neoadjuvant chemotherapy (NAC) and disease-free survival in breast cancer patients. The study enrolled 235 women with breast cancer who underwent multifrequency MR elastography at four time points: before NAC and after 2, 4, and 6 cycles. The study found that higher tumor stiffness and viscosity were associated with lower chances of achieving disease-free survival and pathologic complete response (pCR) during NAC.

Biomechanical parameters derived from MR elastography were found to be positively correlated with stroma fraction and cellularity, providing valuable insights into tumor composition. The study revealed that patients with higher stiffness and viscosity were less likely to achieve pCR during NAC. The reduction in tumor stiffness and viscosity was more pronounced in patients who achieved pCR, emphasizing the importance of monitoring biomechanical changes during treatment.

The study also developed a predictive model incorporating clinicopathologic characteristics and biomechanical parameters, which outperformed the clinicopathologic model in predicting pCR. The combination of progesterone receptor status, HER2 status, and biomechanical parameters at a specific time point showed the highest predictive performance for pCR. Furthermore, the model integrating estrogen receptor, HER2, clinical stage, and viscosity differences at the early stage of NAC demonstrated good discrimination ability for disease-free survival.

The findings suggest that combining biomechanical parameters with clinicopathologic variables can enhance the prediction of treatment response and long-term outcomes in breast cancer patients undergoing NAC. This personalized approach may lead to more effective treatment strategies tailored to individual patient characteristics. Further validation studies involving larger cohorts and multiple centers are recommended to confirm the study’s findings and improve patient care in breast cancer treatment.