***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Contrast-enhanced magnetic resonance imaging ( MRI ) was used to monitor the response of patients undergoing neoadjuvant chemotherapy for breast cancer with the aim of undergoing breast-conserving surgery ( BCS ) . Patients were prospect ively recruited to undergo MRI as well as conventional methods of clinical examination , mammography ( MM ) and ultrasonography ( USS ) and response was assessed by each of these methods . Thirty-two patients with primary breast cancer were recruited . Magnetic resonance imaging correlation with histopathological size ( r=0.71 ) was superior to USS ( r=0.65 ) and to MM where tumour size was not measurable following chemotherapy in 71 % of patients . Magnetic resonance imaging had 87.5 % sensitivity ( 95 % CI=68–97 % ) and 50 % specificity ( 95 % CI=16–84 % ) for a PPV ( positive predictive value ) of 99.8 % and NPV ( negative predictive value ) of 80 % for the detection of residual invasive cancer . Magnetic resonance imaging displayed 80 % sensitivity ( 95 % CI=28.4–99.5 % ) and 89 % specificity ( 95 % CI=71–98 % ) to detect pathological pCR in the breast . Eighty-four per cent of recruited patients were identified as potentially suitable c and i date s for BCS following chemotherapy and of those choosing to accept BCS , breast conservation was achieved in 90.5 % , or 65.6 % of all patients . Of those who proceeded to BCS , 9.5 % required a re-do mastectomy because of positive margins ; however , no residual tumour was found on histological examination of mastectomy specimens . Magnetic resonance imaging appears to be superior to conventional methods for assessing pathological response and the low rate of re-operation for positive margins indicates a valuable role in aiding the decision to undergo BCS or mastectomy AIMS We prospect ively 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 15 mm 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 PURPOSE To prospect ively assess accuracy of mammography , clinical examination , ultrasonography ( US ) , and magnetic resonance ( MR ) imaging in preoperative assessment of local extent of breast cancer . MATERIAL S AND METHODS Institutional review board approval and informed patient consent were obtained . Results of bilateral mammography , US , and contrast-enhanced MR imaging were analyzed from 111 consecutive women with known or suspected invasive breast cancer . Results were correlated with histopathologic findings . RESULTS Analysis included 177 malignant foci in 121 cancerous breasts , of which 89 ( 50 % ) foci were palpable . Median size of 139 invasive foci was 18 mm ( range , 2 - 107 mm ) . Mammographic sensitivity decreased from 100 % in fatty breasts to 45 % in extremely dense breasts . Mammographic sensitivity was highest for invasive ductal carcinoma ( IDC ) in 89 of 110 ( 81 % ) cases versus 10 of 29 ( 34 % ) cases of invasive lobular carcinoma ( ILC ) ( P < .001 ) and 21 of 38 ( 55 % ) cases of ductal carcinoma in situ ( DCIS ) ( P < .01 ) . US showed higher sensitivity than did mammography for IDC , depicting 104 of 110 ( 94 % ) cases , and for ILC , depicting 25 of 29 ( 86 % ) cases ( P < .01 for each ) . US showed higher sensitivity for invasive cancer than DCIS ( 18 of 38 [ 47 % ] , P < .001 ) . MR showed higher sensitivity than did mammography for all tumor types ( P < .01 ) and higher sensitivity than did US for DCIS ( P < .001 ) , depicting 105 of 110 ( 95 % ) cases of IDC , 28 of 29 ( 96 % ) cases of ILC , and 34 of 38 ( 89 % ) cases of DCIS . In anticipation of conservation or no surgery after mammography and clinical examination in 96 breasts , additional tumor ( which altered surgical approach ) was present in 30 . Additional tumor was depicted in 17 of 96 ( 18 % ) breasts at US and in 29 of 96 ( 30 % ) at MR , though extent was now overestimated in 12 of 96 ( 12 % ) at US and 20 of 96 ( 21 % ) at MR imaging . After combined mammography , clinical examination , and US , MR depicted additional tumor in another 12 of 96 ( 12 % ) breasts and led to overestimation of extent in another six ( 6 % ) ; US showed no detection benefit after MR imaging . Bilateral cancer was present in 10 of 111 ( 9 % ) patients ; contralateral tumor was depicted mammographically in six and with both US and MR in an additional three . One contralateral cancer was demonstrated only clinical ly . CONCLUSION In nonfatty breasts , US and MR imaging were more sensitive than mammography for invasive cancer , but both MR imaging and US involved risk of overestimation of tumor extent . Combined mammography , clinical examination , and MR imaging were more sensitive than any other individual test or combination of tests PURPOSE Accurate assessment of residual disease after neo-adjuvant chemotherapy ( NEC ) for women with locally advanced and inflammatory breast cancer ( LABC ) is critical for planning surgery . The study 's purpose was to prospect ively determine the optimal method ( clinical examination ( CE ) , mammogram ( MG ) , and magnetic resonance imaging ( MRI ) ) for assessing residual disease after NEC for women with LABC . METHODS Women with LABC who received NEC and surgery were enrolled . Patient demographics , tumor size as measured by CE , MG , and MRI both before and after NEC , and final pathologic size of tumor were collected . Response to NEC  was calculated using RECIST criteria . Paired t-tests and the Pearson correlation were used to compare tumor size on CE , MG , MRI , and final pathology . RESULTS Forty-eight women with 50 LABC were recruited .  Mean pre-NEC tumor size was 8.2 , 5.1 , and 6.2 cm on CE , MG , and MRI . Mean post-NEC tumor size was 2.4 , 4.3 , 3.9 , and 3.6 cm on CE , MG , MRI , and final pathology . The Pearson correlation co-efficient between post-NEC measurements and pathology was 0.63 ( CE ) , 0.15 ( MG ) , and 0.49 ( MRI ) . CONCLUSION We found that there was limited correlation between the extent of residual disease after NEC for patients with LABC as assessed by CE , MG , and MRI as compared to final pathology Background Neoadjuvant chemotherapy ( NAC ) is commonly utilized to treat operable breast cancer . The purpose of this study was to review the findings of ultrasonography ( US ) and magnetic resonance ( MR ) imaging in patients treated with breast conservation surgery ( BCS ) after NAC with a focus on intrinsic subtypes . Methods Eighty-six patients underwent BCS after NAC .  The tumors were classified into four subgroups by receptor status . US and MR were performed before and after NAC . The tumor diameters in US and MR after NAC were examined for correlations with pathological tumor distances in the specimens from BCS after NAC . Results The correlation coefficient ( r ) of US to pathological tumor size was 0.3 in all tumors , 0.6 in HER2-type tumors , and 0.7 in triple negative breast cancers ( TNBC ) . The correlation coefficient of tumor size in MR to pathological tumor size was 0.9 in TNBC , and other correlations were not statistically significant . Conclusions The correlation between tumor size in MR and pathological tumor size in triple negative breast cancers corresponded best . This information is one of the clues to selecting patients for BCS after NAC PURPOSE To determine the role of magnetic resonance ( MR ) mammography in detection and assessment of extent of tumors with extensive intraductal component ( EIC+ ) . MATERIAL AND METHODS In a prospect i ve study , 233 consecutive women with a suspicious lesion underwent preoperative MR mammography and 209 invasive ductal carcinomas were detected . We studied the prediction of intraductal spread on mammography ( MX ) , ultrasound ( US ) and MR . We compared the size of the total lesion on MX , US and MR and correlated it with histopathology . Enhancement patterns on MR were described . RESULTS Of 209 invasive ductal carcinomas , 50 were EIC+ ( 24 % ) . MX predicted intraductal spread in EIC+ carcinomas in 48.5 % , US in 34.2 % and MR in 68 % . Compared to MX and US , MR was best in assessment of total tumor size . On MR , ductal spread in EIC+ tumors presented as ductal or linear enhancement , long spicules , a regional enhancing area or nodules adjacent to a mass . CONCLUSION MR had the highest sensitivity to predict intraductal spread and was superior in assessing total tumor size Background : Inadequately treated multifocal and multicentric disease results in increased local recurrence following breast-conserving surgery . The accurate preoperative diagnosis of multifocal/centric breast cancer would facilitate the planning of appropriate surgery and prevent reoperation for residual disease . While triple assessment remains the established diagnostic technique , its sensitivity for the diagnosis of multifocal disease remains poor . Dynamic contrast enhanced Magnetic Resonance Imaging ( DCE-MRI ) of the breast represents an alternative emerging diagnostic modality that has been shown to be highly sensitive for the delineation of primary breast cancer . The aim of this study was to prospect ively compare the diagnostic accuracy of DCE-MRI of the breast with conventional triple assessment for the preoperative diagnosis of multifocal/centric breast cancer . Methods : Patients were recruited from the symptomatic breast clinics . All patients underwent st and ard triple assessment and DCE-MRI .  The MRI scans were reported by a single radiologist blinded to the results of the triple assessment . Surgery was then planned accordingly to all available scan results and the specimens examined by a single pathologist . All patients who did not undergo surgery have been followed up for a minimum of 18 months . Results : A total of 334 women were recruited . There were 178 ( 52 % ) cancers that were histologically confirmed and multifocal/centric breast cancer was diagnosed provisionally by the preoperative investigations in 68 ( 38 % ) ; multifocal n = 33 , multicentric n = 35 , of these patients . In this group , subsequent histology confirmed multifocal/centric disease in 50 ( 73.5 % ) : multifocal n = 15 , multicentric n = 35 . Unifocal cancer was found in 15 ( 22 % ) and benign disease in 3 ( 4.4 % ) . The result ant sensitivity , specificity , positive , and negative predictive values were 18 % , 100 % , 100 % , and 76 % for triple assessment and 100 % , 86 % , 73 % , and 100 % for DCE-MRI . Conclusion : DCE-MRI identified a subgroup of breast cancer patients with multifocal/centric disease not evident on st and ard triple assessment . MRI of the breast should be considered for the preoperative planning of surgery for primary breast cancer This study investigated the role of magnetic resonance imaging ( MRI ) in evaluation of pathologically complete response and residual tumors in patients who were receiving neoadjuvant chemotherapy ( NAC ) for both positive and negative HER‐2 breast cancer Summary Purpose . To prospect ively compare the ability of clinical examination , mammography , vascularity-sensitive ultrasound , and magnetic resonance imaging ( MRI ) to determine pathologic complete response ( CR ) in breast cancer patients undergoing neoadjuvant chemotherapy .  Patients and methods . Participants were women with primary measurable , operable invasive breast cancer ( Stages I – III ) who presented to the University of Michigan Breast Care Center . Eligibility criteria were based on clinical need for chemotherapy as part of the overall treatment plan . 
    Output:
    
MRI proved more accurate in determining residual disease than physical examination , mammography and ultrasound .
Diagnostic accuracy of  MRI  after neoadjuvant chemotherapy could be influenced by treatment regimen and breast cancer subtype .
Conclusions Breast MRI  accuracy for assessing residual disease after neoadjuvant chemotherapy is good and surpasses other diagnostic means .
However , both overestimation and underestimation of residual disease extent could be observed .
Main Messages• Breast MRI  accuracy for assessing residual disease is good and surpasses other diagnostic means.• Correlation coefficients of residual tumour size assessed by MRI and pathology were considered good.• However , both overestimation and underestimation of residual disease were observed.• Diagnostic accuracy of MRI seems to be affected by treatment regimen and breast cancer subtype