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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2026, Vol. 20 ›› Issue (05): 422-426. doi: 10.3877/cma.j.issn.1674-3946.2026.05.005

• Original Article • Previous Articles    

Study on MRI manifestations for evaluating the timing of surgical treatment after neoadjuvant therapy for breast cancer

Xinye Gu1, Jia Song1, Jie Wang1, Yajie Li1, Bo Wang1,†(), Jianfeng Gu2   

  1. 1 Department of Breast and Thyroid Surgery, No1 People's Hospital of Changshu, Changshu Jiangsu Province 215500, China
    2 Department of General Surgery, No1 People's Hospital of Changshu, Changshu Jiangsu Province 215500, China
  • Received:2025-12-05 Online:2026-10-26 Published:2026-09-25
  • Contact: Bo Wang
  • Supported by:
    2023 Changshu Second Batch of Key Medical Disciplines-General Surgery(CSZDXK202301)

Abstract:

Objective

To explore the tumor growth of breast cancer (BC) during the interval from the completion of neoadjuvant therapy (NAT) to surgery.

Methods

The clinical data of 106 breast cancer patients after neoadjuvant therapy treated between January 2020 and November 2025 were retrospectively analyzed. Among them, 68.9% received chemotherapy alone (chemotherapy-only group), and 31.1% received chemotherapy combined with anti-human epidermal growth factor receptor 2 (HER2) therapy (combined therapy group). Continuous variables with normal distribution were expressed as (

±s), and categorical variables were presented as [cases (%)]. Pearson correlation coefficient and regression analysis were used to examine the correlations between ordinal variables, as well as between ordinal and continuous variables. P<0.05 was considered statistically significant.

Results

The interval from the end of neoadjuvant therapy to surgery ranged from 8 to 28 days, with a mean of (15.0±3.2) days. The 95% reference range of the interval was 9 to 21 days, and all patients underwent surgery within 4 weeks (28 days) after NAT completion. No significant correlations were observed between each time interval (interval from NAT completion to surgery, interval from NAT completion to MRI examination, interval from post-NAT MRI to surgery) and tumor size recorded in pathological reports. The only parameter significantly correlated with pathological tumor size was the tumor size measured by MRI after neoadjuvant therapy (r=0.820), (P<0.001). The difference in tumor size between post-NAT MRI measurement and surgical pathology showed no correlation with the time interval from NAT completion to surgery (P>0.05). The ratio of residual tumor size on post-NAT MRI to the interval from NAT completion to surgery was significantly correlated with pathological tumor size (P<0.001), indicating that neoadjuvant therapy still exerted favorable effects for several weeks after treatment completion.

Conclusion

All enrolled patients underwent surgery within 4 weeks after neoadjuvant therapy. No significant correlation was found between time interval and tumor progression. Combined with the conventional surgical window of 2-4 weeks in domestic and international clinical practice for breast cancer after neoadjuvant therapy, performing surgery within 2 to 4 weeks after the completion of neoadjuvant chemotherapy is reasonable. This time window is unlikely to cause clinically meaningful changes in residual tumor size.

Key words: Breast Neoplasms, Magnetic Resonance Imaging, Neoadjuvant Therapy

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