FIGURE 4.

Four case examples of breast cancer patients receiving neoadjuvant chemotherapy. The images are maximum intensity projection at baseline and follow-up examinations after 4 weeks and after completing the entire course. The top patient has an immediately operable tumor, but elects to receive NAC to facilitate surgery and achieve a better outcome. The second patient has inoperable cancer and shows a great response to NAC, which not only facilitates surgery but also further allows breast conservation. The third patient has an invasive lobular cancer, which appears to respond well; however, in the post-NAC specimen examination, the scattered cells are seen in the entire original tumor bed. For lobular cancer and non-mass lesions, minimum residual disease may present as scattered cells or cell clusters, and underestimated by magnetic resonance imaging. The last patient shows a complete response in primary cancer, but the partial response in the lymph node, suggesting the need for axillary dissection and axillary radiation