For patients with non-metastatic or locally advanced breast cancer, MRI imaging is used to follow response to neoadjuvant chemotherapy (NAC) and determine treatment plan. However, MRI radiological complete response is not always concordant with pathological complete response. In a cohort of patients imaged at our institution with non-metastatic/locally advanced breast cancer, we report that 24% of post-NAC final MRI imaging is discordant with the final pathology report. We also show that many of these MRI false negatives demonstrate residual intermediate to high grade DCIS and contain microcalcifications.
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