Present role and future perspectives of the evaluation of the effect of primary chemotherapy by breast imaging

Recently, primary chemotherapy has been used not only for locally advanced breast cancers but also operable cases in an adjuvant setting. Therefore, many randomized clinical trials for primary chemotherapy have been coducted all over the world, with the result that more than one-third of the cases have become nonpalpable (clinical CR). On the contrary, accurate determination of the surgical margin has become more difficult. If some cancer remains as a nonpalpable lesion, it must be detected. Breast MRI has been assuming an important role in the assessment of the extent of cancer and does so more accurately than conventional modalifies such as mammography and ultrasonography. Image-guided biopsy or mapping is promising and should be developed as soon as possible. In this article, some promising modalities for the detection of residual lesions after primary chemotherapy are extensively reviewed. © Springer, Part of Springer Science+Business Media.