Predicting Pathologic Responsive to Neoadjuvant Chemotherapy in Patients with Locally Advanced Breast Cancer by Radiomics of Multiparametric MR

2020 ◽  
Author(s):  
nannan Lu ◽  
jie Dong ◽  
xin Fang ◽  
lufang Wang ◽  
wei Jia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Tumor Size ◽  
Locally Advanced Breast Cancer ◽  
Clinical Stage ◽  
Locally Advanced ◽  
Adc Values

Abstract Background:Neoadjuvant chemotherapy for breast cancer was short of recognized treatment scheme and prediction factor. Diffusion weighted magnetic imaging can predict treatment response in patients with locally advanced breast cancer undergoing neoadjuvant chemotherapy. Methods:Fifty patients of breast cancer (mean age, 48.7 years) with stage II-III who underwent neoadjuvant chemotherapy and preoperative MRI were retrospectively evaluated between 2016 and 2020. Association between preoperative breast MRI findings or clinicopathological features and effect of neoadjuvant chemotherapy were studied. Risk factors were identified by multivariate logistic regression analysis. Results:Multivariate logistics regression analysis showed that clinical stage (OR, 0.104; 95% CI: 0.021, 0.516; p=0.006) at baseline and standard apparent diffusion coefficient (ADC) change (OR, 9.865; 95% CI: 1.024, 95.021; p=0.048) were predictive factors of neoadjuvant chemotherapy. The percentage of standard ADC value increasing in pCR group was larger than that in non-pCR group at first time point (p<0.05). The AUC of ROC curve was 0.828 (95% CI: 0.681, 0.975; p<0.05). In pCR group, change of standard ADC values was greater compared with that in tumor size at first follow-up (p<0.05). It was correlation between change of standard ADC values and tumor diameter at first follow-up (r, 0.438; p<0.05). Triple-negative patients in pCR group had higher change of standard ADC values than that in non-pCR groupat first follow-up (p>0.05).Conclusion:Standard ADC values change, clinical stage at baseline were closely related to the effect of neoadjuvant chemotherapy. The change of standard ADC values advanced reduction of tumor size at first follow-up and can predict effect of neoadjuvant chemotherapy in the early stage.

scholarly journals Locally Advanced Breast Cancer (LABC): Real-World Outcome of Patients From Cancer Institute, Chennai

2021 ◽  
pp. 767-781
Author(s):  
Manikandan Dhanushkodi ◽  
Velusamy Sridevi ◽  
Viswanathan Shanta ◽  
Ranganathan Rama ◽  
Rajaraman Swaminathan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Neoadjuvant Chemotherapy ◽  
Triple Negative Breast Cancer ◽  
Tumor Size ◽  
Triple Negative ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced

PURPOSE There are sparse data on the outcome of patients with locally advanced breast cancer (LABC). This report is on the prognostic factors and long-term outcome from Cancer Institute, Chennai. METHODS This is an analysis of untreated patients with LABC (stages IIIA-C) who were treated from January 2006 to December 2013. RESULTS Of the 4,577 patients with breast cancer who were treated, 2,137 patients (47%) with LABC were included for analysis. The median follow-up was 75 months (range, 1-170 months), and 2.3% (n = 49) were lost to follow-up at 5 years. The initial treatment was neoadjuvant concurrent chemoradiation (NACR) (77%), neoadjuvant chemotherapy (15%), or others (8%). Patients with triple-negative breast cancer had a pathologic complete response (PCR) of 41%. The 10-year overall survival was for stage IIIA (65.1%), stage IIIB (41.2%), and stage IIIC (26.7%). Recurrence of cancer was observed in 27% of patients (local 13% and distant 87%). Multivariate analysis showed that patients with a tumor size > 10 cm (hazard ratio [HR], 2.19; 95% CI, 1.62 to 2.98; P = .001), hormone receptor negativity (HR, 1.45; 95% CI, 1.22 to 1.72; P = .001), treatment modality (neoadjuvant chemotherapy, HR, 0.56; 95% CI, 0.43 to 0.73; P = .001), lack of PCR (HR, 2.36; 95% CI, 1.85 to 3.02; P = .001), and the presence of lymphovascular invasion (HR, 1.97; 95% CI, 1.60 to 2.44; P = .001) had decreased overall survival. CONCLUSION NACR was feasible in inoperable LABC and gave satisfactory long-term survival. PCR was significantly higher in patients with triple-negative breast cancer. The tumor size > 10 cm was significantly associated with inferior survival. However, this report acknowledges the limitations inherent in experience of management of LABC from a single center.

MRI tumor volume for predicting response to neoadjuvant chemotherapy in locally advanced breast cancer: Findings from ACRIN 6657/CALGB 150007

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. 529-529
Author(s):  
N. Hylton ◽  
J. Blume ◽  
C. Gatsonis ◽  
R. Gomez ◽  
W. Bernreuter ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Tumor Size ◽  
Tumor Volume ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathologic Response ◽  
Advanced Breast ◽  
Tumor Diameter

529 Background: American College of Radiology Imaging Network (ACRIN) trial 6657, the imaging component of the I-SPY trial (CALGB 150007/150012), is testing MRI for predicting response to treatment and stratifying risk-of-recurrence in patients with locally-advanced breast cancer. We report preliminary results evaluating MRI for prediction of pathologic response. Methods: Women with ≥3 cm invasive breast cancer receiving neoadjuvant chemotherapy (NACT) with anthracycline-cyclophosphamide (AC) followed by a taxane (T) were enrolled from May 2002 to March 2006. MRI was performed prior to NACT (t1), after 1 cycle AC (t2), between AC and T (t3), and following T prior to surgery (t4). MRI tumor size assessments included longest diameter (MRLD) and tumor volume (MRVol). Clinical size (clinsize) and mammographic longest diameter (MGLD) were also recorded. Linear dimension was measured by the radiologist for MGLD and MRLD; MRVol was calculated by computer using signal enhancement ratio (SER) thresholds. Change in clinical and MRI variables at t2 were compared for ability to predict pathologic complete response (pCR). Results: 237 patients were enrolled at 9 institutions. 216 patients with complete imaging were analyzed. Of tumor size measurements at t4, MRVol showed the strongest correlation with pathsize among clinsize (r = 0.44), MGLD (ns), MRLD (r = 0.28) and MRVol (r = 0.61). Early change in MRVol measured at t2 was the only variable predictive of pCR among clinsize (p = 0.14, 0.15), MRLD (p = 0.40, 0.07), MRVol (p = 0.02, 0.01) and peak SER (p = 0.53, 0.72) in univariate and multivariate logistic regression, respectively. Conclusions: Tumor response measured volumetrically by MRI is a stronger and earlier predictor of pathologic response after NACT than clinical exam or tumor diameter. This work is funded by NIH/ACRIN U01 CA79778; CALGB CA31946, CA33601; NCI SPORE CA58207. [Table: see text]

Residual cancer burden (RCB) is practical and may be more informative than pathological response following neoadjuvant chemotherapy (NC) for locally advanced breast cancer (LABC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21103-21103
Author(s):  
D. Sivasubramaniam ◽  
R. Komrokji ◽  
S. Dhaliwal ◽  
V. Sundarajan ◽  
Z. Nahleh
Keyword(s):  
Breast Cancer ◽  
Regression Analysis ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Cox Regression ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Pathological Response ◽  
P Value ◽  
Cox Regression Analysis

21103 Background: Complete pathological response (pCR) has been considered a reliable endpoint to assess the benefit of NC. However, different pathological responses ranging from near complete response to resistance would likely indicate different prognostic groups. Method: We studied patients with locally advanced breast cancer (LABC) who received NC between 2001–2006 at the University of Cincinnati. Pathological response to therapy was evaluated. In addition, RCB was quantified according to MD Anderson RCB Calculator index that combines pathologic measurements of primary tumor (size and cellularity) and nodal metastases (number and size). We examined the correlation between pCR, RCB, event-free survival (EFS) and over all survival (OS) by Cox regression analyses. Result: Pathological slides of 32 patients were analyzed. Median age 52, 38% white and 62% African American. Stage IIB 12% , Stage IIIA 19%, Stage IIIB 53% and Stage IIIC 16% . 72% invasive ducal, 6% invasive lobular and 22% inflammatory cancer. Forty seven percent of tumors were ER +/or PR+ , 53% ER-/PR-, 28% HER-2 /neu + ( IHC 3+ or FISH HER2 gene to chromosome 17 ration > 2.2). Tumor response was as follows: 22% (n=7) achieved pCR , RCB scores ranged between 0- 4.87. By univariate Cox regression analysis, RCB correlated with EFS {Hazard ratio (HR) 1.57 (95% CI 1.04–2.38), p-value 0.018}, and with OS {HR 1.74 (95% CI 0.91 -3.32), p value-0.09}. However, pCR did not seem to correlate with EFS {HR 0 .24 (95%CI 0.03 -1.86–2.38), p-value .172} or OS {HR 0.03 (95% CI 0–89),p value-0.40}. By multivariate Cox regression analysis, RCB was noted to be an independent predictive variable for EFS {HR 1.59 (95% CI 1.04–2.43), p value-0.033} while pCR was not {HR 0.90 (95% CI 0.52–1.57), p value-0.7. Conclusion: RCB was easily quantifiable and appears to be a better predictor of outcome following neoadjuvant chemotherapy in LABC compared to pCR. Higher RCB scores were associated with higher EFS and lower rate of OS. Prospective trials are needed to further evaluate the role of RCB as an endpoint following NC. No significant financial relationships to disclose.

scholarly journals Level of education, background and clinical stage as prognostic factors according RMST function in patients with early and locally advanced breast cancer: a single institution experience from Romania

2021 ◽  
Author(s):  
Irina Niță ◽  
Cornelia Nițipir ◽  
Ștefania Andreea Toma ◽  
Alexandra Maria Limbău ◽  
Edvina Pirvu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Advanced Breast Cancer ◽  
Tumor Size ◽  
Locally Advanced Breast Cancer ◽  
Clinical Stage ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Lymph Node Status ◽  
Level Of Education

Background and aims. Our aim is to examine the relationship between the level of education, background, tumor size and lymph node status on the treatment outcome in a group of patients with early and locally advanced breast cancer (BC) by using the restricted mean survival time (RMST), which summarizes treatment effects in terms of event-free time over a fixed period of time. Methods. We evaluated the prognostic values in 143 patients treated for early BC at Elias University Emergency Hospital, Bucharest, Romania and followed up for a maximum of 36 months. The protocol was amended to include the levels of education (gymnasium, high school, or university), the background (urban or rural) and the clinical stage (primary tumor (T) and regional nodes (N)). The methodology consisted in using a Kaplan–Meier analysis and RMST for the entire sample and Cox regression, for the variables with statistical influence. The principal endpoints of the study were overall survival (OS) and progression free survival (PFS). Results. The level of education had impact both on RMST OS (35.30 vs. 26.70) and death HR (hazard ratio) in the group of patients with general school level, compared with those with graduated university. In this study, the urban or rural background did not impact the outcome, probably because in this study we included predominantly patients from urban areas (83%). Although clinical tumor size measurements did not impact the outcome, the clinical staged lymph node influenced both OS (p=0.0500) and PFS (p=0.0006) for the patients with palpable or imaging proof of lymph node involvement of station 2 or 3. Conclusions. RMST provides an intuitive and explicit way to express the effect of those risk factors on OS and PFS in a cohort of early breast cancer patients. Low level of education and high-grade clinical lymph node status negatively influences the outcome of this cohort of BC patients.

scholarly journals Predicting Response to Neoadjuvant Chemotherapy in Women with Locally Advanced Breast Cancer in Kenya: Utility of Ki67

2021 ◽  
Vol 18 (1) ◽  
pp. 23-28
Author(s):  
Edwin Mogere ◽  
Joseph Githaiga ◽  
Francis Owilla ◽  
Mary Mungania ◽  
Daniel Ojuka
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Breast Cancer ◽  
Tumor Size ◽  
Locally Advanced Breast Cancer ◽  
Locally Advanced ◽  
Tumor Biology ◽  
Advanced Breast ◽  
P Value ◽  
Response To Neoadjuvant Chemotherapy

Background: Ki67 levels have been shown to have good predictive value in breast cancer treatment. There is paucity of data on Ki67 levels in predicting response to neoadjuvant chemotherapy (NACT) in Kenya. This study evaluated the utility of Ki67 in predicting response to NACT. Methods: This was a prospective observational study carried out at Kenyatta National Hospital between December 2017 and January 2019 onpatients with locally advanced breast cancer. We recruited 61 women through consecutive sampling technique. Data collected included patient demographics, pre-treatment tumor size, Ki67 levels and tumor biology. After 3 cycles of first-line chemotherapy, ultrasonography was used to determine response. Data were analyzed by SPSS for proportion of change in tumor size. The response was correlated with tumor biology and pretreatment levels of Ki67 using chisquare at a 95% confidence interval. A p-value <0.05 was considered statistically significant. Results: The response rate after 3 cycles of NACT was 39.4%, sensitivity and specificity of Ki67 levels were 70.8% and 43.2% respectively with a cut-off value of 32.5%. Conclusions: Ki67 was found to predict response in our context at a rate of 39.4% at 20% cutoff after 3 cycles. Keywords: Ki67, Breast cancer, Neoadjuvant chemotherapy

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