Dynamic Contrast-Enhanced MRI Evaluation of Pathologic Complete Response in Human Epidermal Growth Factor Receptor 2 (HER2)-Positive Breast Cancer After HER2-Targeted Therapy
Publication date: Available online 20 August 2019Source: Academic RadiologyAuthor(s): Laura Heacock, Alana Lewin, Abimbola Ayoola, Melanie Moccaldi, James S. Babb, Sungheon G. Kim, Linda MoyRationale and ObjectivesPathologic complete response (pCR) in patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer after HER2-targeted therapy correlates increased disease-free survival and decreased mastectomy rates. The aim of this study was to explore tumor shrinkage patterns and initial tumor enhancement with pCR in HER2-positive breast cancer.Materials and MethodsThis was an institutional review board-approved retrospective analysis of 51 HER2 positive breast cancer patients with breast MRI both pre- and post-HER2-targeted therapy. Initial enhancement ratio (IER, initial enhancement percentage over baseline at first postcontrast imaging), pattern of tumor shrinkage, and Dynamic contrast enhanced (DCE)-MRI imaging features were assessed. Wilcoxon rank, Spearman correlation, Fisher's exact, and Mann-Whitney tests were used to correlate MRI imaging features with pCR. IER reader agreement was evaluated by intraclass correlation. Binary logistic regression was used to evaluate multivariate associations with pCR.Results56.9% (29/51) of patients had pCR at surgery. Concentric tumor shrinkage pattern was associated with pCR (p = 0.001, Area under the curve (AUC) 0.778): accuracy 80.4%, specificity 96.6%, and sensitivity of 59.1%. There was no association with p...
Abstract PURPOSE: To identify a sub-group at high risk for local-regional recurrence (LRR) from T1-2 breast cancer with negative lymph nodes (N0) after mastectomy by using a meta-analysisMethods and materials:Published studies on the relationship between clinical features and loco-regional recurrence of breast cancer were identified from public databases, including PubMed, EMBASE, and the Cochrane library. High-risk features for LRR in this patient population were defined based on the pooled results of meta-analysis.ResultsFor the meta-analysis, a total of 11,244 breast cancers with pT1-2N0 after mastectomy from 2...
ConclusionsFor intermediate-risk as well as early stage high-risk BC patients, the DEGRO Breast Cancer Expert Panel recommends the use of PMRT following SSME and NSME when a 10-year locoregional recurrence risk is likely to be greater than 10%, as estimated by clinical and biological risk factors. Subvolume-only radiation is discouraged outside of trials. The impact of adequate systemic treatment and the value of radiotherapy on optimal locoregional tumor control, wit h the goal of less than 5% LRR at 10-years follow-up, has to be verified in prospective trials.
AbstractBackgroundAdolescents and young adults (AYAs; age
ConclusionsAsian women are more likely to have high grade, larger and HER2+ breast cancers than European women. In spite of this, they had better breast cancer outcomes. Possible explanations include the differences in adherence to endocrine therapy, age, BMI and comorbidities.
A 72-year-old woman presented with 2-month history of “bruises” on the left breast. She was treated for a left breast cancer 6 years earlier. She previously had stage IA (cT1cN0M0) invasive ductal carcinoma that was estrogen receptor/progesterone receptor positive and Her2 negative. She underwent partial mastectomy and sentinel lymph node biopsy th at confirmed stage pT1cN0. In the setting of bilateral silicone breast implants, she received adjuvant partial breast irradiation to 36 Gy in 9 fractions twice daily, targeting the seroma with 1.5 to 2 cm margins.
Abstract PURPOSE: Ductal carcinoma in situ (DCIS) is widely recognized as the precursor of invasive ductal carcinoma (IDC). We aimed to analyze the clinicopathological characteristics and clinical outcomes of coexisting DCIS component in IDC and its clinical significance according to molecular subtypes. METHODS: Data from 3001 patients with IDC (79.4%) and IDC/DCIS (20.6%) who underwent surgery from January 2009 to June 2016 were retrospectively assessed. The clinical outcomes of IDC with coexistent DCIS in different molecular subtypes were evaluated. RESULTS: IDC/DCIS patients were more likely to be younger (P
AbstractPatients with breast cancer desire to avoid chemotherapy-induced alopecia because it induces mental stress during treatment. Scalp cooling can suppress chemotherapy-induced alopecia without increasing the risk of scalp metastasis; however, in certain cases, alopecia cannot be prevented. The use of properly fitted scalp cooling caps has not yet been explored in Asian patients. Here, we report a case of hair regrowth using a properly fitted scalp cooling cap during adjuvant chemotherapy for breast cancer. A 51-year-old Japanese woman who was recalled by screening mammography for grouped amorphous calcifications and a...
ConclusionsThe investigative team developed a novel breast cancer treatment DA that is acceptable to women ≥70 years with a history of ER+, HER2-, early stage breast cancer. Next, the DA's efficacy needs to be tested with diverse older women newly diagnosed with breast cancer.
AbstractPurposeDuctal carcinoma in situ (DCIS) is widely recognized as the precursor of invasive ductal carcinoma (IDC). We aimed to analyze the clinicopathological characteristics and clinical outcomes of coexisting DCIS component in IDC and its clinical significance according to molecular subtypes.MethodsData from 3001 patients with IDC (79.4%) and IDC/DCIS (20.6%) who underwent surgery from January 2009 to June 2016 were retrospectively assessed. The clinical outcomes of IDC with coexistent DCIS in different molecular subtypes were evaluated.ResultsIDC/DCIS patients were more likely to be younger (P