Abstract
Triple-negative breast cancer (TNBC) is a heterogeneous disease with variable response to neoadjuvant systemic therapy (NAST). Patients with pathologic complete response (pCR) following NAST have improved survival. Our goal was to establish readily accessible imaging biomarker to identify which TNBC patients will have pCR. Building on prior favorable results in the literature, we hypothesized that manually measured tumor volume changes at DCE-MRI may predict pCR early during NAST. This prospective study included 287 stage I-III TNBC patients who underwent DCE-MRI at baseline, after two and four cycles of NAST, with pCR accessed at surgery (NCT02276443). Tumor volume and percentage tumor volume reduction were calculated, and their correlation with pCR was evaluated. Our study showed that manually extracted tumor volume changes from DCE-MRI early during NAST were able to predict pCR with high accuracy and can serve as a clinically relevant imaging biomarker for prediction of NAST response in TNBC patients.