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. 2019 Nov 8;9:16372. doi: 10.1038/s41598-019-52785-3

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© The Author(s) 2019

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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(A,B) Box and whisker plots of changes in (A) ADC values and (B) tumor size before and after the first cycle of treatment (MR1 vs. MR2). The horizontal line within each box represents the median value. In (A), the outliers represent two non-responder cases: 1) ΔADC = 54.24%, there was a complete response in the breast lesion, however a positive axillary lymph node remained after surgery, thereby resulting in a non-pCR classification; 2) ΔADC = 61.56%, a substantial inflammatory effect was observed after the first cycle of NCT, and this resulted in high T2 signal intensity, an increase in ADC value, and an increase in breast enhancement, despite the absence of a complete pathological response after treatment. The morphology of both cases indicated non-mass enhancement lesions. In (B), the outlier represents a non-mass enhancement tumor that was fragmented and showed scattered areas throughout the tumor burden in MR2.