Complete response on MR imaging after neoadjuvant chemotherapy in breast cancer patients: factors of radiologic-pathologic discordance

Publication date: Available online 21 June 2019Source: European Journal of RadiologyAuthor(s): Woo Jung Choi, Hak Hee Kim, Joo Hee Cha, Hee Jung Shin, Eun Young Chae, Ga Young YoonAbstractPurposeTo evaluate the radiologic and clinicopathologic factors in radiologic-pathologic discordance (false-negative results) in breast cancer patients who demonstrate radiologic complete response (rCR) in MR imaging after neoadjuvant chemotherapy (NAC).MethodOur institutional review board approved this retrospective study. We included 209 consecutive patients who showed rCR in MR imaging after NAC. rCR was diagnosed when the original lesion site showed no enhancement. Pathologic CR (pCR) was defined as the complete absence of both invasive cancer and ductal carcinoma in situ in the breast upon pathology. Clinicopathologic and radiologic factors affecting the radiologic-pathologic correlation were analyzed.ResultspCR was noted in 108 patients (51.7%); the remaining 101 (48.3%) had residual lesion on pathology. False negative rCR findings were significantly more frequent in cases of 1 or 2 histologic grade (p =  0.001), low tumor-infiltrating lymphocytes (p =  0.004), and luminal A or B subtype (p 
Source: European Journal of Radiology - Category: Radiology Source Type: research

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Conclusion: The texture analysis for breast DCE-MRI proposed in this study demonstrated potential utility in HER2 2+ status discrimination. Background Human epidermal growth factor receptor 2 (HER2) is an orphan tyrosine kinase receptor. It is reported that HER2 is overexpressed in 15–20% of breast cancers. Overexpression of HER2 in breast cancer correlates with shortened disease-free survival. Compared with HER2-negative patients, patients with HER2-positive breast cancers have a poor prognosis, a high probability of lymph node metastasis and a high risk of recurrence (1–3). However, previous studies h...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
CONCLUSION: MSP participants with invasive breast cancer can generally be treated with less intensive surgical and systemic therapy than non-participants, even if interval cancers are also taken into account. Future studies should also investigate quality of life after a diagnosis of invasive carcinoma in screening participants. PMID: 30149831 [PubMed - in process]
Source: Deutsches Arzteblatt International - Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research
Conclusions DCIS may be completely eradicated by NAC±trastuzumab. However, associated microcalcificatios probably persist. Patients with locally advanced breast cancer with substantial DCIS may still opt for NAC and breast conservation as the DCIS component may respond and even completely disappear following NAC. Residual widespread microcalcificatios after NAC do not necessarily indicate residual cancer. Larger studies are needed to direct the surgical management of these patients.
Source: European Journal of Surgical Oncology (EJSO) - Category: Surgery Source Type: research
CONCLUSIONS: In this study we developed a decision treatment model for patients with DCIS based on Bayesian Decision Theory. The results were consistent with scientific evidence and clinical practice. Finally, we performed the computer implementation of the model in order to be used in routine clinical practice.DISCUSION: The model developed in the study is the first decision model that takes into account the uncertainty calculation based on the expected utility of each decision on recurrence-free survival for each patient.Citation Format: Fujiki Y, Yamamoto Y, Yamamoto-Ibusuki M, Goto R, Tomiguchi M, Sueta A, Takeshita T,...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Poster Session Abstracts Source Type: research
Conclusions: There proved to be no apparent superiority of PEM in predicting pCR at the interim time point. Positron emission mammography had greater diagnostic capability for detecting residual cancer after all courses of NAC.
Source: Clinical Nuclear Medicine - Category: Nuclear Medicine Tags: Original Articles Source Type: research
CONCLUSIONS: There proved to be no apparent superiority of PEM in predicting pCR at the interim time point. Positron emission mammography had greater diagnostic capability for detecting residual cancer after all courses of NAC. PMID: 28072617 [PubMed - as supplied by publisher]
Source: Clinical Genitourinary Cancer - Category: Cancer & Oncology Authors: Tags: Clin Nucl Med Source Type: research
We present a patient with advanced breast cancer who had paradoxically increased malignant microcalcifications concomitant with primary tumor regression after undergoing neoadjuvant chemotherapy. After the neoadjuvant chemotherapy, the follow-up mammogram revealed that local, fine pleomorphic microcalcifications had markedly increased. Pathologically, these calcifications were ductal carcinoma in situ. We concluded that, in patients with breast cancer undergoing neoadjuvant chemotherapy, newly developed microcalcifications on follow-up mammograms should be carefully evaluated, and any suspicious malignant microcalcificatio...
Source: Journal of Breast Cancer - Category: Cancer & Oncology Tags: J Breast Cancer Source Type: research
Abstract Purpose To evaluate the accuracy of residual microcalcifications on mammogram (MG) in predicting the extent of the residual tumor after neoadjuvant systemic treatment (NST) in patients with locally advanced breast cancer and to evaluate factors affecting the accuracy of MG microcalcifications using magnetic resonance imaging (MRI) as a reference. Methods The patients who underwent NST and showed suspicious microcalcifications on MG comprised our study population. Clinicopathologic and imaging (MG, MRI) findings were investigated. Agreemen...
Source: Annals of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Conclusion Among imaging modalities, breast MRI can potentially distinguish between ypT0 and ypTis after NCT, especially in patients with triple-negative breast cancer. This information can help clinicians evaluate tumor response to NCT and plan surgery for breast cancer patients of all subtypes except for those with HER2-enriched tumors after NCT.
Source: PLoS One - Category: Biomedical Science Authors: Source Type: research
Abstract PURPOSE: To evaluate the accuracy of residual microcalcifications on mammogram (MG) in predicting the extent of the residual tumor after neoadjuvant systemic treatment (NST) in patients with locally advanced breast cancer and to evaluate factors affecting the accuracy of MG microcalcifications using magnetic resonance imaging (MRI) as a reference. METHODS: The patients who underwent NST and showed suspicious microcalcifications on MG comprised our study population. Clinicopathologic and imaging (MG, MRI) findings were investigated. Agreement between image findings and pathology was assessed and facto...
Source: Ann Oncol - Category: Cancer & Oncology Authors: Tags: Ann Surg Oncol Source Type: research
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