Over the past decades, women with breast cancer are increasingly treated with systemic therapy, in particular with neoadjuvant chemotherapy (NAC). Unfortunately, patients undergoing NAC treatment experience side effects, due to the fact that chemotherapy drugs target all cells in the body that grow and divide rapidly. On top of that, in ~30% of the patients, NAC treatment does not result in tumor size reduction. At the moment there is no non-invasive method to evaluate the early effects of systemic treatment. We hypothesized that metabolic changes will take place prior to morphological changes of the tumor, especially early on in the course of NAC treatment.
This thesis presents the possibility of detecting altered tumor metabolism in breast cancer after the first cycle of NAC treatment (~3 weeks) and identified biomarkers from 31P-MRS and CEST-MRI as promising predictors of pathological response. Also, technological advances in the form of a bilateral breast coil were presented, which makes it feasible to perform a routinely used clinical MR protocol at 7 T MRI. These are the first steps towards routinely performed clinical breast MR examinations at 7 T and non-invasive early response prediction of NAC treatment in breast cancer patients.