Controversies Concerning the Use of Neoadjuvant Systemic Therapy for Primary Breast Cancer

2012 ◽  
Vol 36 (7) ◽  
pp. 1480-1485 ◽  
Author(s):  
Manfred Kaufmann ◽  
Thomas Karn ◽  
Eugen Ruckhäberle
Keyword(s):  
Breast Cancer ◽  
Systemic Therapy ◽  
Primary Breast Cancer ◽  
Neoadjuvant Systemic Therapy

Abstract P6-01-03: Change of HER2 status following neoadjuvant systemic therapy in primary breast cancer patients

2015 ◽  
Author(s):  
Atsushi Yoshida ◽  
Naoki Hayashi ◽  
Hiroshi Yagata ◽  
Koyu Suzuki ◽  
Seigo Nakamura ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Systemic Therapy ◽  
Primary Breast Cancer ◽  
Her2 Status ◽  
Breast Cancer Patients ◽  
Neoadjuvant Systemic Therapy

Recommendations from an International Consensus Conference on the Current Status and Future of Neoadjuvant Systemic Therapy in Primary Breast Cancer

2011 ◽  
Vol 19 (5) ◽  
pp. 1508-1516 ◽  
Author(s):  
Manfred Kaufmann ◽  
Gunter von Minckwitz ◽  
Elefhterios P. Mamounas ◽  
David Cameron ◽  
Lisa A. Carey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systemic Therapy ◽  
Primary Breast Cancer ◽  
Consensus Conference ◽  
Current Status ◽  
International Consensus ◽  
Neoadjuvant Systemic Therapy

scholarly journals MRI-Based Radiomics Analysis for the Pretreatment Prediction of Pathologic Complete Tumor Response to Neoadjuvant Systemic Therapy in Breast Cancer Patients: A Multicenter Study

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2447
Author(s):  
Renée W. Y. Granzier ◽  
Abdalla Ibrahim ◽  
Sergey P. Primakov ◽  
Sanaz Samiei ◽  
Thiemo J. A. van Nijnatten ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Systemic Therapy ◽  
Tumor Response ◽  
Added Value ◽  
Breast Cancer Patients ◽  
Neoadjuvant Systemic Therapy ◽  
Clinical Models ◽  
Combined Models ◽  
Complete Tumor

This retrospective study investigated the value of pretreatment contrast-enhanced Magnetic Resonance Imaging (MRI)-based radiomics for the prediction of pathologic complete tumor response to neoadjuvant systemic therapy in breast cancer patients. A total of 292 breast cancer patients, with 320 tumors, who were treated with neo-adjuvant systemic therapy and underwent a pretreatment MRI exam were enrolled. As the data were collected in two different hospitals with five different MRI scanners and varying acquisition protocols, three different strategies to split training and validation datasets were used. Radiomics, clinical, and combined models were developed using random forest classifiers in each strategy. The analysis of radiomics features had no added value in predicting pathologic complete tumor response to neoadjuvant systemic therapy in breast cancer patients compared with the clinical models, nor did the combined models perform significantly better than the clinical models. Further, the radiomics features selected for the models and their performance differed with and within the different strategies. Due to previous and current work, we tentatively attribute the lack of improvement in clinical models following the addition of radiomics to the effects of variations in acquisition and reconstruction parameters. The lack of reproducibility data (i.e., test-retest or similar) meant that this effect could not be analyzed. These results indicate the need for reproducibility studies to preselect reproducible features in order to properly assess the potential of radiomics.

Clinical Course of Breast Cancer Patients with Local-Regional Progression During Neoadjuvant Systemic Therapy

2021 ◽  
Author(s):  
Leisha C. Elmore ◽  
Henry M. Kuerer ◽  
Carlos H. Barcenas ◽  
Benjamin D. Smith ◽  
Makesha V. Miggins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Systemic Therapy ◽  
Clinical Course ◽  
Breast Cancer Patients ◽  
Neoadjuvant Systemic Therapy

ASO Visual Abstract: Clinical Course of Breast Cancer Patients with Local Regional Progression During Neoadjuvant Systemic Therapy

2021 ◽  
Author(s):  
Leisha C. Elmore ◽  
Henry M. Kuerer ◽  
Carlos H. Barcenas ◽  
Benjamin D. Smith ◽  
Makesha V. Miggins ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Systemic Therapy ◽  
Clinical Course ◽  
Breast Cancer Patients ◽  
Neoadjuvant Systemic Therapy

scholarly journals The NeST (Neoadjuvant systemic therapy in breast cancer) study: National Practice Questionnaire of United Kingdom multi-disciplinary decision making

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
I. Whitehead ◽  
◽  
G. W. Irwin ◽  
F. Bannon ◽  
C. E. Coles ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systemic Therapy ◽  
Tumour Response ◽  
Multidisciplinary Teams ◽  
Diverse Range ◽  
Radiological Monitoring ◽  
Original Tumour ◽  
Neoadjuvant Systemic Therapy ◽  
Axillary Node Clearance ◽  
The Uk

Abstract Background Neoadjuvant systemic therapy (NST) is increasingly used in the treatment of breast cancer, yet it is clear that there is significant geographical variation in its use in the UK. This study aimed to examine stated practice across UK breast units, in terms of indications for use, radiological monitoring, pathological reporting of treatment response, and post-treatment surgical management. Methods Multidisciplinary teams (MDTs) from all UK breast units were invited to participate in the NeST study. A detailed questionnaire assessing current stated practice was distributed to all participating units in December 2017 and data collated securely usingREDCap. Descriptive statistics were calculated for each questionnaire item. Results Thirty-nine MDTs from a diverse range of hospitals responded. All MDTs routinely offered neoadjuvant chemotherapy (NACT) to a median of 10% (range 5–60%) of patients. Neoadjuvant endocrine therapy (NET) was offered to a median of 4% (range 0–25%) of patients by 66% of MDTs. The principal indication given for use of neoadjuvant therapy was for surgical downstaging. There was no consensus on methods of radiological monitoring of response, and a wide variety of pathological reporting systems were used to assess tumour response. Twenty-five percent of centres reported resecting the original tumour footprint, irrespective of clinical/radiological response. Radiologically negative axillae at diagnosis routinely had post-NACT or post-NET sentinel lymph node biopsy (SLNB) in 73.0 and 84% of centres respectively, whereas 16% performed SLNB pre-NACT. Positive axillae at diagnosis would receive axillary node clearance at 60% of centres, regardless of response to NACT. Discussion There is wide variation in the stated use of neoadjuvant systemic therapy across the UK, with general low usage of NET. Surgical downstaging remains the most common indication of the use of NAC, although not all centres leverage the benefits of NAC for de-escalating surgery to the breast and/or axilla. There is a need for agreed multidisciplinary guidance for optimising selection and management of patients for NST. These findings will be corroborated in phase II of the NeST study which is a national collaborative prospective audit of NST utilisation and clinical outcomes.

scholarly journals Exploring breast cancer response prediction to neoadjuvant systemic therapy using MRI-based radiomics: A systematic review

2019 ◽  
Vol 121 ◽  
pp. 108736 ◽  
Author(s):  
R.W.Y. Granzier ◽  
T.J.A. van Nijnatten ◽  
H.C. Woodruff ◽  
M.L. Smidt ◽  
M.B.I. Lobbes
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Systemic Therapy ◽  
Response Prediction ◽  
Neoadjuvant Systemic Therapy

scholarly journals Avoiding Axillary Sentinel Lymph Node Biopsy after Neoadjuvant Systemic Therapy in Breast Cancer: Rationale for the Prospective, Multicentric EUBREAST-01 Trial

Cancers ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3698
Author(s):  
Toralf Reimer ◽  
Aenne Glass ◽  
Edoardo Botteri ◽  
Sibylle Loibl ◽  
Oreste D. Gentilini
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Systemic Therapy ◽  
Lymph Node Biopsy ◽  
Biological Behavior ◽  
Axillary Surgery ◽  
Node Biopsy ◽  
Neoadjuvant Systemic Therapy

Currently, axillary surgery for breast cancer is considered only as staging procedure, since the risk of developing metastasis depends on the biological behavior of the primary. The postsurgical therapy should be considered on the basis of biologic tumor characteristics rather than nodal involvement. Improvements in systemic treatments for breast cancer have increased the rates of pathologic complete response (pCR) in patients receiving neoadjuvant systemic therapy (NAST), offering the opportunity to de-escalate surgery in patients who have a pCR. European Breast Cancer Research Association of Surgical Trialists (EUBREAST)-01 is a clinical trial in which only patients with the highest likelihood of having a pCR after NAST (triple-negative or HER2-positive breast cancer) will be included and type of surgery will be defined according to the response to NAST rather than on the classical T (for tumor size in the breast) and N (for axillary lymph node involvement) status. In the discussed trial, axillary surgery will be eliminated completely (no axillary sentinel lymph node biopsy) for initially clinical node-negative (cN0) patients with radiologic complete remission and a breast pCR in the lumpectomy specimen. The trial design is a multicenter single-arm study with a limited number of patients (n = 267), which might give practice-changing results in a short period of time, sparing the time and the costs of a randomized comparison.

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