scholarly journals Diagnostic Value of Contrast-enhanced Digital Mammography Versus Contrast-enhanced MRI for Detecting Residual Disease after Neoadjuvant Chemotherapy for Breast Cancer

2020 ◽  
Author(s):  
Eun Young Kim ◽  
Ji-Sup Yun ◽  
Yong Lai Park ◽  
Chan Heun Park ◽  
Mi-Ri Kwon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Digital Mammography ◽  
Residual Disease ◽  
Pearson Correlation ◽  
Preoperative Evaluation ◽  
Diagnostic Value ◽  
Breast Cancer Patients ◽  
Residual Lesion ◽  
Contrast Enhanced

Abstract Background: Preoperative evaluation of breast cancer using contrast-enhanced digital mammography (CEDM) as a possible alternative to contrast-enhanced magnetic resonance imaging (CEMRI) has gained acceptance. Our aim is to compare the diagnostic performance of CEDM and CEMRI for chemotherapeutic response in breast cancer patients who underwent neoadjuvant chemotherapy (NAC).Methods: From November 2017 to October 2018, 30 patients with invasive carcinoma who performed both CEDM and CEMRI were included. Residual malignancy sizes after NAC were compared with histopathological results. The diagnostic performances for detecting residual cancers were compared using Lin concordance and Pearson correlation coefficients.Results: Thirty patients were included for the analysis. Mean tumor size after NAC was 1.22 cm (range: 0–7.0 cm) for CEDM and 1.13 cm (range: 0–5.1cm) for CEMRI compared with 1.89 cm (range: 0–12.0 cm) at final pathology measurement. Sensitivity for identifying residual lesion was for CEDM and CEMRI is as follows (CEDM 62.5%, 95% CI 40.6–81.2, CEMRI 66.7%, 95% CI 44.7–84.4). The positive predictive value (PPV) for residual lesion was 93.8% (95% CI 69.8–99.8) for CEDM and 88.9% (95% CI 65.3–98.6) for CEMRI. CEDM had a mean difference from pathology measurement of 0.668 cm, with a concordance coefficient of 0.202 and a Pearson correlation coefficient of 0.231 (p=0.220).Conclusions: Diagnostic value of CEDM for detecting residual tumor extent after NAC was comparable to that of CEMRI.

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 Contrast-Enhanced Mammography (CEM) for Detecting Residual Disease after Neoadjuvant Chemotherapy: A Comparison with Breast Magnetic Resonance Imaging (MRI)

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Filipe Ramos Barra ◽  
Alaor Barra Sobrinho ◽  
Renato Ramos Barra ◽  
Mayra Teixeira Magalhães ◽  
Laira Rodrigues Aguiar ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Magnetic Resonance Imaging ◽  
Neoadjuvant Chemotherapy ◽  
Tumor Size ◽  
Residual Disease ◽  
Pearson Correlation ◽  
Newly Diagnosed ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri

Objective. To evaluate the performance of contrast-enhanced mammography (CEM) compared to magnetic resonance imaging (MRI) for estimating residual tumor size after neoadjuvant chemotherapy (NAC) in women with newly diagnosed breast cancer. Methods. The institutional review board approved this study. This prospective study included women with newly diagnosed breast cancer who underwent breast CEM and MRI at the end of the last cycle of NAC and before definitive surgery. Size of residual malignancy on post-NAC CEM and MRI was compared with surgical pathology. Agreements and correlations of CEM and MRI measurements with histological size were assessed. Results. Thirty-three patients were included with a mean age of 45 years (range 22–76). The sensitivity, specificity, and positive and negative predictive value for detection of residual disease of CEM were 76%, 87.5%, 95%, and 86.4%, and those of MRI were 92%, 75%, 92%, and 75%. Comparing CEM to MRI, the mean difference was −0.8 cm, concordance coefficient was 0.7, and Pearson correlation was 0.7 (p = 0.0003). The concordance coefficient between measurements of each imaging modality and pathologic tumor size was 0.7 for CEM and 0.4 for MRI. Pearson correlation was 0.8 for CEM and 0.5 for MRI. Mean differences between CEM, MRI, and residual histopathological tumor size were 0.8 cm and 1.8 cm, respectively. Conclusions. CEM has good correlation and agreement with histopathology for measuring residual disease after NAC. CEM was comparable to MRI, showing high positive predictive value and specificity for detecting residual disease.

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.

Genomic profiling of residual tumor after neoadjuvant chemotherapy for breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e12106-e12106
Author(s):  
Masaya Hattori ◽  
Padma Sheila Rajagopal ◽  
Lise Sveen ◽  
Galina Khramtsova ◽  
Toshio Yoshimatsu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Residual Disease ◽  
Tissue Bank ◽  
Residual Tumor ◽  
Cancer Tissue ◽  
Genomic Profiling ◽  
Breast Cancer Patients ◽  
Her2 Positive ◽  
Metastatic Recurrence

e12106 Background: Patients who have residual disease after neoadjuvant chemotherapy (NAC) have a higher risk of metastatic recurrence. Residual disease likely includes therapy-resistant subclones of breast cancer cells, which untreated lead to metastases. The aim of this study was to identify additional adjuvant therapies based on genomic profiling of residual disease post NAC therapy. Methods: Next-generation sequencing of tumor samples from patients (pts) with residual invasive breast cancer after NAC was performed using a Tempus xT, 595 gene panel on matched tumor-normal samples. All samples were obtained from the University of Chicago Breast Cancer tissue bank. Clinical information was obtained from electronic health records and the cancer registry. Results: Of 23 evaluable patients enriched for African Americans, 65% were HER2-positive, 22% TNBC and 13% ER+/HER2-. At a median follow up of 2.9 years, 8 pts (35%) have recurred and 8 were dead. We identified 119 clinically actionable variants in 22 tumors, and the most commonly altered genes were TP53 (18 alterations, 74% of cases), ERBB2 (8, 26%), PIK3CA (7, 30%), CDK4 (4, 17%), MCL1 (4, 17%), and MDM2 (4, 17%). Of significance, 67% of HER2-positive pts had no detectable ERBB2 copy number gain in the residual tumor. 78% of pts had at least one potential druggable target according to CIViC and/or OncoKB: 19 variants in HER2-positive, 8 in HER2-negative. The mean estimated tumor mutation burden (TMB) was 4.34 m/MB (range: 0-26.7), and 13% were considered TMB-high ( > 9 m/MB). No patients had high-microsatellite instability type residual tumors. Conclusions: Many potentially targetable alterations reside in residual disease of both HER2-positive and -negative breast cancer after NAC. Post-NAC treatment targeting these harbored alterations and post-NAC immunotherapy could have impact on the prognosis of breast cancer patients who have residual disease after NAC. [Table: see text]

MRI accuracy in residual disease evaluation in breast cancer patients treated with neoadjuvant chemotherapy

2006 ◽  
Vol 61 (11) ◽  
pp. 946-953 ◽  
Author(s):  
P. Belli ◽  
M. Costantini ◽  
C. Malaspina ◽  
A. Magistrelli ◽  
G. LaTorre ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Residual Disease ◽  
Breast Cancer Patients
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