Abstract
Background: Monitoring response to neoadjuvant chemotherapy (NACT) is essential. MRI, the gold-standard technique, is expensive, time-consuming, difficult to access and can be poorly tolerated. Contrast-enhanced breast tomosynthesis (CE-DBT) combines functional information on vascularity from contrast enhanced mammography (CESM) with structural information obtained at tomosynthesis. We seek to compare CE-DBT with MRI for accuracy of response assessment and patient experience.
Methods: This is a prospective imaging-comparison pilot study of adult female patients with breast cancer undergoing NACT. Participants undergo CE-DBT alongside MRI, before, during and after completion of NACT. Participant questionnaires are completed after initial and end-of-treatment imaging. Comparison between end-of-treatment imaging and pathology and between CE-DBT and MRI will be made.
Results: 17 women (18 cancers) are recruited, target 25 women. Ten have completed treatment with surgical pathology available, one withdrew, thus CE-DBT-pathological correlation is available for 10 tumours (9 women). 47 questionnaires were completed (26 post-CE-DBT, 21 post-MRI).
CESM accurately predicted pathological complete response in 5 cases, with one false negative (6mm residual grade 1 IDC). Of the remaining four tumours, CESM was accurate to within 2mm in two cases; of the two residual multicentric tumours CESM over-estimated one case and under-estimated another.
On 19/24 (79%) of occasions women preferred CE-DBT to MRI. Overall experience was significantly better for CE-DBT (p<0.005); rated as excellent, good and fair in 17,9,0 cases opposed to 8,7,6 for MRI.
Conclusions: Early indications suggest CE-DBT may be a reliable monitoring technique, preferred by patients. Full analysis and comparison with MRI results will be performed.
Methods: This is a prospective imaging-comparison pilot study of adult female patients with breast cancer undergoing NACT. Participants undergo CE-DBT alongside MRI, before, during and after completion of NACT. Participant questionnaires are completed after initial and end-of-treatment imaging. Comparison between end-of-treatment imaging and pathology and between CE-DBT and MRI will be made.
Results: 17 women (18 cancers) are recruited, target 25 women. Ten have completed treatment with surgical pathology available, one withdrew, thus CE-DBT-pathological correlation is available for 10 tumours (9 women). 47 questionnaires were completed (26 post-CE-DBT, 21 post-MRI).
CESM accurately predicted pathological complete response in 5 cases, with one false negative (6mm residual grade 1 IDC). Of the remaining four tumours, CESM was accurate to within 2mm in two cases; of the two residual multicentric tumours CESM over-estimated one case and under-estimated another.
On 19/24 (79%) of occasions women preferred CE-DBT to MRI. Overall experience was significantly better for CE-DBT (p<0.005); rated as excellent, good and fair in 17,9,0 cases opposed to 8,7,6 for MRI.
Conclusions: Early indications suggest CE-DBT may be a reliable monitoring technique, preferred by patients. Full analysis and comparison with MRI results will be performed.
| Original language | English |
|---|---|
| Number of pages | 1 |
| Journal | Breast Cancer Research |
| DOIs | |
| Publication status | Published - 6 Jul 2021 |
| Event | Symposium Mammographicum Conference 2021 - Online Duration: 7 Feb 2021 → 10 Feb 2021 http://chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://sympmamm.org.uk/wp-content/uploads/2021/07/Symposium-Mammographicum-Conference-2021-on-line.pdf |
