Abstract
Background: Increasing numbers of breast cancer patients receive neoadjuvant chemotherapy (NACT). We seek to investigate whether baseline mammographic and ultrasound features are associated with complete pathological response (pCR) after NACT.
Methods: A database of NACT patients was reviewed. Baseline imaging parameters assessed were ultrasound: posterior effect; echo pattern; margin and lesion diameter; mammography: spiculation and microcalcification. Core biopsy grade and immunophenotype were documented. Data were analysed for the whole study group and by immunophenotype.
Results: Of the 222 cancers, 83 (37%) were triple negative (TN), 61 (27%) ER positive/HER-2 negative and 78 (35%) HER-2 positive. A pCR occurred in 46 of 222 cancers (21%). For the whole group, response was associated with high core biopsy grade (grade 3 vs. grade 1 or 2) (26% vs. 9%, p = 0.0044), absence of posterior shadowing on ultrasound (26% vs. 10%, p < 0.001) and the absence of mammographic spiculation (26 vs. 6%, p < 0.001). Within the HER-2 positive group; the absence of shadowing and spiculation remained highly associated with pCR, in addition to small ultrasound size (AUC = 0.71, p < 0.001) and the absence of microcalcification (39% vs. 21%, p < 0.02). On multivariable analysis absence of spiculation and core grade remained significant for the whole cohort, size and absence of spiculation remained significant for HER-2 positive tumours. No feature predicted pCR in TN tumours.
Conclusion: A pCR is less likely when there is mammographic spiculation. Small ultrasound size is associated with pCR in HER-2 positive tumours. These findings may be helpful when discussing NACT and surgical options with patients.
Trial registration: UK Clinical Trials Gateway: registration number 16712.
| Original language | English |
|---|---|
| Article number | 67 |
| Pages (from-to) | 1-7 |
| Number of pages | 7 |
| Journal | Cancer Imaging |
| Volume | 19 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 21 Oct 2019 |
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Keywords
- Breast carcinoma
- Mammography
- Neoadjuvant chemotherapy
- Pathological complete response
- Ultrasound
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Are baseline ultrasound and mammographic features associated with rates of pathological completes response in patients receiving neoadjuvant chemotherapy for breast cancer? / Savaridas, Sarah L. (Lead / Corresponding author); Sim, Yee Ting; Vinnicombe, Sarah J.; Purdie, Colin A.; Thompson, Alastair M.; Evans, Andy.
In: Cancer Imaging, Vol. 19, No. 1, 67, 21.10.2019, p. 1-7.Research output: Contribution to journal › Article
TY - JOUR
T1 - Are baseline ultrasound and mammographic features associated with rates of pathological completes response in patients receiving neoadjuvant chemotherapy for breast cancer?
AU - Savaridas, Sarah L.
AU - Sim, Yee Ting
AU - Vinnicombe, Sarah J.
AU - Purdie, Colin A.
AU - Thompson, Alastair M.
AU - Evans, Andy
N1 - This was retrospective review of data collected as part of a prospective breast cancer imaging study funded by Breast Cancer Now (2012ON46).
PY - 2019/10/21
Y1 - 2019/10/21
N2 - Background: Increasing numbers of breast cancer patients receive neoadjuvant chemotherapy (NACT). We seek to investigate whether baseline mammographic and ultrasound features are associated with complete pathological response (pCR) after NACT.Methods: A database of NACT patients was reviewed. Baseline imaging parameters assessed were ultrasound: posterior effect; echo pattern; margin and lesion diameter; mammography: spiculation and microcalcification. Core biopsy grade and immunophenotype were documented. Data were analysed for the whole study group and by immunophenotype.Results: Of the 222 cancers, 83 (37%) were triple negative (TN), 61 (27%) ER positive/HER-2 negative and 78 (35%) HER-2 positive. A pCR occurred in 46 of 222 cancers (21%). For the whole group, response was associated with high core biopsy grade (grade 3 vs. grade 1 or 2) (26% vs. 9%, p = 0.0044), absence of posterior shadowing on ultrasound (26% vs. 10%, p < 0.001) and the absence of mammographic spiculation (26 vs. 6%, p < 0.001). Within the HER-2 positive group; the absence of shadowing and spiculation remained highly associated with pCR, in addition to small ultrasound size (AUC = 0.71, p < 0.001) and the absence of microcalcification (39% vs. 21%, p < 0.02). On multivariable analysis absence of spiculation and core grade remained significant for the whole cohort, size and absence of spiculation remained significant for HER-2 positive tumours. No feature predicted pCR in TN tumours.Conclusion: A pCR is less likely when there is mammographic spiculation. Small ultrasound size is associated with pCR in HER-2 positive tumours. These findings may be helpful when discussing NACT and surgical options with patients.Trial registration: UK Clinical Trials Gateway: registration number 16712.
AB - Background: Increasing numbers of breast cancer patients receive neoadjuvant chemotherapy (NACT). We seek to investigate whether baseline mammographic and ultrasound features are associated with complete pathological response (pCR) after NACT.Methods: A database of NACT patients was reviewed. Baseline imaging parameters assessed were ultrasound: posterior effect; echo pattern; margin and lesion diameter; mammography: spiculation and microcalcification. Core biopsy grade and immunophenotype were documented. Data were analysed for the whole study group and by immunophenotype.Results: Of the 222 cancers, 83 (37%) were triple negative (TN), 61 (27%) ER positive/HER-2 negative and 78 (35%) HER-2 positive. A pCR occurred in 46 of 222 cancers (21%). For the whole group, response was associated with high core biopsy grade (grade 3 vs. grade 1 or 2) (26% vs. 9%, p = 0.0044), absence of posterior shadowing on ultrasound (26% vs. 10%, p < 0.001) and the absence of mammographic spiculation (26 vs. 6%, p < 0.001). Within the HER-2 positive group; the absence of shadowing and spiculation remained highly associated with pCR, in addition to small ultrasound size (AUC = 0.71, p < 0.001) and the absence of microcalcification (39% vs. 21%, p < 0.02). On multivariable analysis absence of spiculation and core grade remained significant for the whole cohort, size and absence of spiculation remained significant for HER-2 positive tumours. No feature predicted pCR in TN tumours.Conclusion: A pCR is less likely when there is mammographic spiculation. Small ultrasound size is associated with pCR in HER-2 positive tumours. These findings may be helpful when discussing NACT and surgical options with patients.Trial registration: UK Clinical Trials Gateway: registration number 16712.
KW - Breast carcinoma
KW - Mammography
KW - Neoadjuvant chemotherapy
KW - Pathological complete response
KW - Ultrasound
UR - http://www.scopus.com/inward/record.url?scp=85073760108&partnerID=8YFLogxK
U2 - 10.1186/s40644-019-0251-3
DO - 10.1186/s40644-019-0251-3
M3 - Article
C2 - 31639053
VL - 19
SP - 1
EP - 7
JO - Cancer Imaging
JF - Cancer Imaging
SN - 1740-5025
IS - 1
M1 - 67
ER -