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Personalized Medicine, Biomarkers of Risk and Breast MRI

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Breast Oncology: Techniques, Indications, and Interpretation

Abstract

Breast cancer is a heterogeneous disease with inter- and intra-tumor genetic variation impacting predictive and prognostic risk. This chapter discusses the use of breast MRI, the most sensitive imaging modality for high-risk screening and pre-operative assessment, to predict breast cancer risk, to define extent of disease and to monitor neoadjuvant chemotherapeutic response at the level of the individual patient. In the current clinical landscape, immunohistochemical surrogates are used to define molecular subtypes and personalized cancer treatment and care. Radiogenomics involves the correlation of genomic information with imaging features. Feature extraction from breast MRI is being pursued on a large scale as a potential non-invasive means of defining molecular subtypes and/or developing phenotypic biomarkers that can be clinically analogous to commercially available genomic assays. Neoadjuvant chemotherapy, treatment administered in operable cancers before surgery, is increasingly used, allowing for breast conservation in women who would traditionally require mastectomy. As breast cancer genetic molecular subtypes are predictive of recurrence free and overall survival, treatment based on breast cancer molecular subtype and breast MRI is critical in evaluating response though improvement in its sensitivity for pathologic complete response. Breast MRI in the neoadjuvant cohort has provided biomarkers of response and insight into the biologic basis of disease. MRI is at the forefront of technology providing prognostic indicators as well as a crucial tool in personalizing medicine.

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10021, USA

    Elizabeth J. Sutton MDCM, Nina Purvis MPhys, PhD, Katja Pinker-Domenig MD, PhD & Elizabeth A. Morris MD, FACR

  2. Department of Biomedical Imaging and Image-guided Therapy, Division of Molecular and Gender Imaging, Medical University of Vienna/General Hospital Vienna, Vienna, Austria

    Katja Pinker-Domenig MD, PhD

Authors
  1. Elizabeth J. Sutton MDCM
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  2. Nina Purvis MPhys, PhD
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  3. Katja Pinker-Domenig MD, PhD
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  4. Elizabeth A. Morris MD, FACR
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Corresponding author

Correspondence to Elizabeth J. Sutton MDCM .

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Editors and Affiliations

  1. Department of Radiology, New York University Langone Medical Center New York University School of Medicine, New York, USA

    Samantha L. Heller

  2. Department of Radiology, New York University Langone Medical Center New York University School of Medicine, New York, USA

    Linda Moy

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Sutton, E.J., Purvis, N., Pinker-Domenig, K., Morris, E.A. (2017). Personalized Medicine, Biomarkers of Risk and Breast MRI. In: Heller, S., Moy, L. (eds) Breast Oncology: Techniques, Indications, and Interpretation. Springer, Cham. https://doi.org/10.1007/978-3-319-42563-4_17

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  • DOI: https://doi.org/10.1007/978-3-319-42563-4_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42561-0

  • Online ISBN: 978-3-319-42563-4

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