# Monitoring Pharmacological Treatment of Breast Cancer with MRI

## TL;DR

This paper reviews how MRI can improve breast cancer treatment monitoring and outcomes, especially for high-risk patients.

## Contribution

The paper synthesizes recent clinical and technological advances in using MRI for pharmacological treatment monitoring in breast cancer.

## Key findings

- MRI is more sensitive and specific than conventional imaging in detecting breast cancer, especially in dense tissue.
- MRI can assess treatment response and residual disease early, enabling personalized treatment and better outcomes.
- AI-based radiomics and deep learning enhance MRI's ability to predict therapeutic response and molecular subtypes.

## Abstract

Breast cancer is one of the major health threats to women worldwide; thus, a need has arisen to reduce the number of instances and deaths through new methods of diagnostic monitoring and treatment. The present review is the synthesis of the recent clinical studies and technological advances in the application of magnetic resonance imaging (MRI) to monitor the pharmacological treatment of breast cancer. The specific focus is on high-risk groups (carriers of BRCA mutations and recipients of neoadjuvant chemotherapy) and the use of novel MRI methods (dynamic contrast-enhanced (DCE) MRI, diffusion-weighted imaging (DWI), and radiomics tools). All the reviewed studies show that MRI is more sensitive (up to 95%) and specific than conventional imaging in detecting malignancy particularly in dense breast tissue. Moreover, MRI can be used to assess the response and residual disease in a tumor early and accurately for personalized treatment, de-escalate unneeded interventions, and maximize positive outcomes. AI-based radiomics combined with deep-learning models also expand the ability to predict the therapeutic response and molecular subtypes, and can mitigate the risk of overfitting models when using complex methods of modeling. Other developments are hybrid PET/MRI, image guidance during surgery, margin assessment intraoperatively, three-dimensional surgical templates, and the utilization of MRI in surgery planning and reducing reoperation. Although economic factors will always play a role, the diagnostic and prognostic accuracy and capability to aid in targeted treatment makes MRI a key tool for modern breast cancer. The growing complement of MRI and novel curative approaches indicate that breast cancer patients may experience better survival and recuperation, fewer recurrences, and a better quality of life.