scholarly journals Radiological Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Females, Using Standard and Spectral Mammography

2021 ◽  
Author(s):  
Katarzyna Steinhof-Radwańska ◽  
Anna Grazynska ◽  
Andrzej Lorek ◽  
Anna Barczyk Gutkowska ◽  
Joanna Szczudlo Chrascina ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Histopathological Examination ◽  
Tumour Size ◽  
Breast Cancer Patients ◽  
Contrast Enhanced ◽  
Conventional Mammography ◽  
Average Size ◽  
High Level ◽  
Residual Lesions

Abstract Background Morphological assessment and measurement of the residual mass of the breast tumour following neoadjuvant chemotherapy (NACT) is the key to successful surgical treatment. The objective of our study was to evaluate the efficiency of contrast-enhanced spectral mammography (CESM) and conventional mammography (MMG) in detecting CR (complete response) following NACT, as well as to compare the efficiency of conventional mammography and contrast-enhanced spectral mammography is assessing the therapeutic response to NACT in breast cancer patients.Methods A retrospective analysis included 63 breast cancer subjects who had undergone neoadjuvant chemotherapy in the years 2016-2019. The inclusion criteria for the study included diagnosed breast cancer based on a core needle biopsy, a complete set of imaging examinations before the procedure consisted of digital mammography, contrast-enhanced spectral mammography and surgery performed before and after completed neoadjuvant chemotherapy. Results The average size of the tumours prior to neoadjuvant chemotherapy amounted to 34.37 mm for MMG and 34.34 mm for CESM, as well as 17.61 mm for MMG and 8.48 mm for CESM following NACT. The average size of the lesions in histopathological examination was 11.06 mm. Spearman’s analysis revealed a high level of correlation (R=0.89, p<0.01) upon comparing the maximum tumour dimensions prior to neoadjuvant chemotherapy on MMG and CESM, and a moderate level of correlation (R=0.57, p<0.01) upon comparing the maximum tumour dimensions post-NACT on MMG and CESM. While comparing the measurements of the maximum dimensions on MMG and CESM following NACT, with the maximum dimensions in histopathological examination, we can observe a low level of correlation for MMG (R=0.26, p<0.04) and a high level of correlation for CESM (R=0.67, p<0.01). The sensitivity of MMG in forecasting CR amounted to 33.33% and its specificity to 92.86%, whereas the same parameters for CESM were 85.71% and 71.42% respectively.Conclusions CESM demonstrates significantly higher sensitivity than MMG in forecasting CR in female patients receiving NACT due to breast cancer. CESM correlates well with the size of residual lesions in histopathological examination. However, it tends to underestimate the tumour size. In the assessment of post-NACT residual lesions, conventional mammography is an insufficient diagnostic tool.

scholarly journals Contrast-Enhanced Spectral Mammography Assessment of Patients Treated with Neoadjuvant Chemotherapy for Breast Cancer

2021 ◽  
Vol 28 (5) ◽  
pp. 3448-3462
Author(s):  
Katarzyna Steinhof-Radwańska ◽  
Anna Grażyńska ◽  
Andrzej Lorek ◽  
Iwona Gisterek ◽  
Anna Barczyk-Gutowska ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Histopathological Examination ◽  
Evaluation Criteria ◽  
High Sensitivity ◽  
Complete Response ◽  
Low Energy ◽  
Contrast Enhanced ◽  
Residual Lesions

Background: Evaluating the tumor response to neoadjuvant chemotherapy is key to planning further therapy of breast cancer. Our study aimed to evaluate the effectiveness of low-energy and subtraction contrast-enhanced spectral mammography (CESM) images in the detection of complete response (CR) for neoadjuvant chemotherapy (NAC) in breast cancer. Methods: A total of 63 female patients were qualified for our retrospective analysis. Low-energy and subtraction CESM images just before the beginning of NAC and as a follow-up examination 2 weeks before the end of chemotherapy were compared with one another and assessed for compliance with the postoperative histopathological examination (HP). The response to preoperative chemotherapy was evaluated based on the RECIST 1.1 criteria (Response Evaluation Criteria in Solid Tumors). Results: Low-energy images tend to overestimate residual lesions (6.28 mm) and subtraction images tend to underestimate them (2.75 mm). The sensitivity of low-energy images in forecasting CR amounted to 33.33%, while the specificity was 92.86%. In the case of subtraction CESM, the sensitivity amounted to 85.71% and the specificity to 71.42%. Conclusions: CESM is characterized by high sensitivity in the assessment of CR after NAC. The use of only morphological assessment is insufficient. CESM correlates well with the size of residual lesions on histopathological examination but tends to underestimate the dimensions.

scholarly journals Contrast-enhanced spectral mammography in the radiological assessment of response to neoadjuvant chemotherapy in breast cancer

2021 ◽  
pp. e521
Author(s):  
Anna Grażyńska ◽  
Sofija Antoniuk ◽  
Katarzyna Steinhof-Radwańska
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Neoadjuvant Chemotherapy ◽  
Residual Disease ◽  
Tumour Size ◽  
Breast Cancer Diagnosis ◽  
Chemotherapy Response ◽  
Resonance Imaging ◽  
Contrast Enhanced

Accurate morphological assessment and measurement of the residual disease following neoadjuvant chemotherapy are vital for the effective surgical treatment in patients with breast cancer. Neoadjuvant chemotherapy response is measured by RECIST 1.1 criteria (Response Evaluation Criteria in Solid Tumors), and the classification of the specific therapeutic responses is based on the difference in the tumour size prior to and after chemotherapy. There are currently a few methods of imaging used in the assessment of the neoadjuvant chemotherapy response. Conventional mammography remains the most popular method, whereas magnetic resonance imaging is considered the most effective ones. Nonetheless, the available methods tend to be imperfect and limited, and therefore, new methods are constantly investigated. Contrast-enhanced spectral mammography is a relatively new method used in breast cancer diagnosis, which involves the phenomenon of neoangiogenesis of cancerous tumours, allowing contrast enhancement in the areas of vessel proliferation in the background of the surrounding breast tissue. Contrast-enhanced spectral mammography presents sensitivity similar to magnetic resonance imaging in breast cancer detection, and can be an efficient method used in monitoring neoadjuvant chemotherapy response.

scholarly journals Accuracy and Reproducibility of Contrast-Enhanced Mammography in the Assessment of Response to Neoadjuvant Chemotherapy in Breast Cancer Patients with Calcifications in the Tumor Bed

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 435
Author(s):  
Valentina Iotti ◽  
Moira Ragazzi ◽  
Giulia Besutti ◽  
Vanessa Marchesi ◽  
Sara Ravaioli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Residual Disease ◽  
Residual Tumor ◽  
False Positives ◽  
Breast Cancer Patients ◽  
Surgical Specimen ◽  
Tumor Bed ◽  
Contrast Enhanced

This study aimed to evaluate contrast-enhanced mammography (CEM) accuracy and reproducibility in the detection and measurement of residual tumor after neoadjuvant chemotherapy (NAC) in breast cancer (BC) patients with calcifications, using surgical specimen pathology as the reference. Pre- and post-NAC CEM images of 36 consecutive BC patients receiving NAC in 2012–2020, with calcifications in the tumor bed at diagnosis, were retrospectively reviewed by two radiologists; described were absence/presence and size of residual disease based on contrast enhancement (CE) only and CE plus calcifications. Twenty-eight patients (77.8%) had invasive and 5 (13.9%) in situ-only residual disease at surgical specimen pathology. Considering CE plus calcifications instead of CE only, CEM sensitivity for invasive residual tumor increased from 85.7% (95% CI = 67.3–96%) to 96.4% (95% CI = 81.7–99.9) and specificity decreased from 5/8 (62.5%; 95% CI = 24.5–91.5%) to 1/8 (14.3%; 95% CI = 0.4–57.9%). For in situ-only residual disease, false negatives decreased from 3 to 0 and false positives increased from 1 to 2. CEM pathology concordance in residual disease measurement increased (R squared from 0.38 to 0.45); inter-reader concordance decreased (R squared from 0.79 to 0.66). Considering CE plus calcifications to evaluate NAC response in BC patients increases sensitivity in detection and accuracy in measurement of residual disease but increases false positives.

scholarly journals Assessment of the predictive role of oestrogen and progesterone receptor status in breast cancer patients treated with neoadjuvant chemotherapy: A retrospective analysis for 689 patients

2020 ◽  
Author(s):  
Ying Ye ◽  
Rui Chen ◽  
Yong Fu ◽  
Yang Peng ◽  
Fanli Qu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Progesterone Receptor ◽  
Tumour Size ◽  
Tumour Response ◽  
Therapy Response ◽  
Breast Cancer Patients ◽  
Predictive Role ◽  
Her 2

Abstract Background : To explore the predictive indicators in hormone receptor (HR)-positive breast cancer (BC) patients receiving neoadjuvant chemotherapy (NACT) and to evaluate the value of quantitative oestrogen receptor (ER) and progesterone receptor (PR) in predicting tumour response. Methods : Six hundred eighty-nine BC patients with HR-positive status who were treated with anthracycline, epirubicin and taxane NACT treatment were retrospectively analysed. Clinical and pathological features of the patients were used to evaluate the response to NACT. Results : Patients with larger tumour sizes ( OR 1.657 CI 1.186-2.313 p=0.003 ), those who were in a premenopausal status ( OR 1.458 CI 1.039-2.045 p=0.029 ) and those with higher Ki67 levels ( OR 1.735 CI 1.231-2.444 p=0.002 ) exhibited a better therapy response. Among the patients in the postmenopausal subgroup, a lower pretreatment ER or PR expression were associated with a reduction in tumour size, and the cut-off values for ER and PR were 87.5% and 65%, respectively ( p=0.006 and p=0.05 ). Decreased expression of ER and PR was also observed after NACT treatment ( p=0.028 and p<0.001, respectively ) but played only a predictive role in the Her-2-negative subgroup; the cut-off values for decreased ER and PR were 17.5% and 26.5%, respectively ( p=0.044 and p<0.001 ). Conclusions : Semiquantified pretreatment HR expression can be used to predict the response of NACT in postmenopausal BC patients. Decreased ER and PR expression is also associated with a reduction in tumour size in Her-2-negative subtypes treated with NACT.

scholarly journals Identification of sentinel lymph nodes using contrast-enhanced ultrasound in breast cancer patients who underwent neoadjuvant chemotherapy.

2019 ◽  
Vol 5 (suppl) ◽  
pp. 59-59
Author(s):  
Xiufeng Wu ◽  
Lina Tang ◽  
Yi Zeng ◽  
Xia Chen
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
False Negative ◽  
False Negative Rate ◽  
Breast Cancer Patients ◽  
Identification Rate ◽  
Contrast Enhanced ◽  
Sensitivity Specificity

59 Background: The aim of this prospective study was to evaluate the feasibility of contrast-enhanced ultrasonography (CEUS) for the identification of sentinel lymph node (SLN) in breast cancer patients with cN0 following neoadjuvant chemotherapy (NAC). Methods: Patients with cN0 following NAC (n=66) received a periareolar injection of SonoVue followed by ultrasound (US) to identify contrast-enhanced SLN before surgery. All patients underwent axillary lymph node dissection for verification of axillary node status after the SLN biopsy. The identification rate, sensitivity, specificity, accuracy, false negative rate, negative predictive value, positive predictive value was recorded. Results: In almost all cases, the SLNs were easily identified with an identification rate of 98.5 % (65/66). Compared with pathological diagnosis, sensitivity, specificity, accuracy, and false negative rate of CEUS for SLN diagnosis were 66.7%, 95.8%, 78.8%, and 14.3% respectively. Conclusions: Identification of SLN by CEUS is a technically feasible method with an identification rate as high as 98.5%. [Table: see text][Table: see text]

Sign in / Sign up

Export Citation Format

Share Document