WEDNESDAY, May 23 (HealthDay News) — Getting chemotherapy before
breast cancer surgery can mean the difference between a mastectomy or a
breast-conserving lumpectomy, experts say.
And new research shows that getting an MRI during the first round of
chemo can help predict quickly if the cancer will respond to the
treatment.
MRI works better than clinical examination of the tumor, the standard
way to assess how well the chemotherapy is working, said researcher Dr.
Nola Hylton, a professor of radiology and biomedical imaging at the
University of California, San Francisco.
Although many doctors order an MRI after all rounds of chemotherapy are
finished, Hylton’s team did MRIs before, during and after a chemo cycle,
and also when all of the chemotherapy was finished.
“What we are trying to do is fine-tune MRI so it can be a more
sensitive measure of whether people are responding [to the chemo],” Hylton
said.
At all points, MRI measurements of tumors were more accurate than a
clinical exam, in which the doctor palpates the tumor and evaluates
whether it is responding to the chemo.
“This initial finding said that after only one cycle of treatment,
measuring the change in the tumor volume [by MRI] was very predictive of
whether that patient ultimately had a good response to all the
chemotherapy,” Hylton said.
Previous research has found that women who get chemotherapy before
their surgery are more likely to be able to have breast-conserving surgery
than women given chemo after their surgery.
The new study included 216 women, aged 26 to 68, who had invasive
breast cancer (stage 2 or 3).
The study is scheduled to be published in the June issue of the journal
Radiology.
The findings don’t surprise Dr. Joanne Mortimer, director of the
Women’s Cancer Program and co-director of the Breast Cancer Program at the
City of Hope Comprehensive Cancer Center in Duarte, Calif.
“It’s a great idea,” Mortimer said of performing the MRI sooner. “The
MRI seems to be a more objective way [to gauge effectiveness of
chemo].”
Already, Mortimer said, many doctors are ordering an MRI after
chemotherapy is complete. “The practice is to perform the MRI after the
entire chemo session,” she said.
The cost of an MRI ranges greatly, but without insurance coverage it is
often $1,000 or higher.
“When you give chemotherapy, the blood supply to the tumor changes,”
Mortimer said.
The MRI detects activity such as blood vessel formation in tumors, a
marker of whether the tumor is responding to chemo, Hylton noted.
More information
To learn more about MRIs, visit the American College of Radiology.
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