Tailoring Neoadjuvant Chemotherapy for Locally Advanced Breast Cancer: A Historical Prospective Study

Chemotherapy ◽  
2012 ◽  
Vol 58 (2) ◽  
pp. 95-101 ◽  
Author(s):  
Alona Zer ◽  
Shulamit Rizel ◽  
Rony Braunstein ◽  
Rinat Yerushalmi ◽  
Daniel Hendler ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Prospective Study ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast

scholarly journals Role of conservative breast surgery in locally advanced breast cancer after neoadjuvant chemotherapy

2019 ◽  
Vol 6 (2) ◽  
pp. 459
Author(s):  
Alaa A. El Sisi ◽  
Mahmoud G. Hagag ◽  
Mohammed G. Hegazi
Keyword(s):  
Breast Cancer ◽  
Local Recurrence ◽  
Neoadjuvant Chemotherapy ◽  
Prospective Study ◽  
Advanced Breast Cancer ◽  
Breast Surgery ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Conservative Breast Surgery

Background: Locally advanced breast cancer represents 20%-25% of breast cancer patients at diagnosis. The aim of this prospective study was to assess the feasibility and the oncologic outcome in the treatment of patients of locally advanced breast cancer that had been downstaged by neoadjuvant chemotherapy to the extent that makes them eligible for conservative breast surgery.Methods: This prospective study was done on 50 female patients who were diagnosed with locally advanced breast cancer and received neoadjuvant chemotherapy to downstage cancer making it eligible for conservation, managed and treated at El Menoufia University Hospital and Tanta Cancer Center from March 2017 to March 2018 after applying inclusion and exclusion criteria. The collected data were organized, tabulated and statistically analyzed using SPSS software.Results: Significant difference between pre and post-chemotherapy tumor size in patients with locally advanced breast cancer. Conservative breast surgery with intraoperative frozen section assured free margins in all of them with acceptable cosmetic outcome. No local recurrence recorded after one year of follow up.Conclusions: In the present study, it was observed that conventional neoadjuvant chemotherapy is effective in downgrading the tumor size and axillary lymph nodes in patients with locally advanced breast cancer. Breast conservation after neoadjuvant chemotherapy is safe in terms of local recurrence.

scholarly journals The Prognostic Impact of Body Composition for Locally Advanced Breast Cancer Patients Who Received Neoadjuvant Chemotherapy

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 608
Author(s):  
Toshiaki Iwase ◽  
Aaroh Parikh ◽  
Seyedeh S. Dibaj ◽  
Yu Shen ◽  
Tushaar Vishal Shrimanker ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Composition ◽  
Adipose Tissue ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathologic Complete Response ◽  
Complete Response ◽  
Advanced Breast

Our previous study indicated that a high amount of visceral adipose tissue was associated with poor survival outcomes in patients with early breast cancer who received neoadjuvant chemotherapy. However, inconsistency was observed in the prognostic role of body composition in breast cancer treatment outcomes. In the present study, we aimed to validate our previous research by performing a comprehensive body composition analysis in patients with a standardized clinical background. We included 198 patients with stage III breast cancer who underwent neoadjuvant chemotherapy between January 2007 and June 2015. The impact of body composition on pathologic complete response and survival outcomes was determined. Body composition measurements had no significant effect on pathologic complete response. Survival analysis showed a low ratio of total visceral adipose tissue to subcutaneous adipose tissue (V/S ratio ≤ 34) was associated with shorter overall survival. A changepoint method determined that a V/S ratio cutoff of 34 maximized the difference in overall survival. Our study indicated the prognostic effect of body composition measurements in patients with locally advanced breast cancer compared to those with early breast cancer. Further investigation will be needed to clarify the biological mechanism underlying the association of V/S ratio with prognosis in locally advanced breast cancer.

scholarly journals Prediction of Chemoresistance in Women Undergoing Neo-Adjuvant Chemotherapy for Locally Advanced Breast Cancer: Volumetric Analysis of First-Order Textural Features Extracted from Multiparametric MRI

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
M. M. Panzeri ◽  
C. Losio ◽  
A. Della Corte ◽  
E. Venturini ◽  
A. Ambrosi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Volumetric Analysis ◽  
Pathological Response ◽  
Advanced Breast ◽  
Washout Rate ◽  
First Order

Purpose. To assess correlations between volumetric first-order texture parameters on baseline MRI and pathological response after neoadjuvant chemotherapy (NAC) for locally advanced breast cancer (BC). Materials and Methods. 69 patients with locally advanced BC candidate to neoadjuvant chemotherapy underwent MRI within 4 weeks from the start of therapeutic regimen. T2, DWI, and DCE sequences were analyzed and maps were generated for Apparent Diffusion Coefficient (ADC), T2 signal intensity, and the following dynamic parameters: k-trans, peak enhancement, area under curve (AUC), time to maximal enhancement (TME), wash-in rate, and washout rate. Volumetric analysis of these parameters was performed, yielding a histogram analysis including first-order texture kinetics (percentiles, maximum value, minimum value, range, standard deviation, mean, median, mode, skewness, and kurtosis). Finally, correlations between these values and response to NAC (evaluated on the surgical specimen according to RECIST 1.1 criteria) were assessed. Results. Out of 69 tumors, 33 (47.8%) achieved complete pathological response, 26 (37.7%) partial response, and 10 (14.5%) no response. Higher levels of AUCmax (p value = 0.0338), AUCrange (p value = 0.0311), and TME75 (p value = 0.0452) and lower levels of washout10 (p value = 0.0417), washout20 (p value = 0.0138), washout25 (p value = 0.0114), and washout30 (p value = 0.05) were predictive of noncomplete response. Conclusion. Histogram-derived texture analysis of MRI images allows finding quantitative parameters predictive of nonresponse to NAC in women affected by locally advanced BC.

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