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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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Images obtained from a 58-year-old female diagnosed with LABC HER-2 breast cancer who presented pCR after mastectomy. The ΔADC% increase between MR1 and MR2 was 54% (true positive to early prediction of NCT). No size change (false negative at this point) was observed after the first cycle of treatment. Because of its high restriction signal in diffusion, the patient was diagnosed with partial radiological response by DCE and DWI at MR3 (both false negative at this point). (A) Axial DWI at MR1 shows an extensive area with high signal intensity, denoting diffusion restriction. (B) Axial DWI at MR2 shows high signal intensity at the same site as shown in (A). (C) Axial DWI at MR3 shows a significant reduction in the area of diffusion restriction and high signal intensity at the tumor site. (D) Hematoxylin and eosin staining of a histological section of the mastectomy product after NCT. Residual disease is absent, while stromal fibrosis and vascular neoformation are observed, compatible with response to treatment (10x magnification).