Naoko Matsuda1, Kumiko Kida2, Sachiko Ohde3, Koyu Suzuki4, Hideko Yamauchi2, Seigo Nakamura5, Hiroko Tsunoda6. 1. Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. naomatsu@luke.ac.jp. 2. Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. 3. Center for Clinical Epidemiology, St. Luke's Life Science Institute, Tokyo, Japan. 4. Department of Pathology, St. Luke's Life Science Institute, Tokyo, Japan. 5. Division of Breast Surgical Oncology, Department of Surgery, Showa University, Tokyo, Japan. 6. Department of Radiology, St. Luke's International Hospital, Tokyo, Japan.
Abstract
INTRODUCTION: Ultrasound (US) is conventionally performed to determine effects of neoadjuvant chemotherapy (NAC) on breast cancer. In patients with triple-negative breast cancer (TNBC), higher pathological complete response (pCR) predicts the most favorable survival outcome. We aimed to predict pCR to NAC using echogenicity changes in US region of interest (ROI) in patients with TNBC. METHODS AND MATERIALS: We retrospectively determined clinicopathological characteristics of 52 patients with primary TNBC who underwent NAC. Changes in echogenicity for pCR and non-pCR patients were calculated from ratios of tumor to fat (T/F) in their ROIs, before and after NAC, as [T/F After/T/F Before] and [T/F After - T/F Before]. RESULTS: Of the 52 patients (median age: 52 years; range 26-77 years), 20 (38.5%) achieved pCR, which was significantly associated with change in ROI ratio (P < 0.01). The cut-off values for ROI ratio and ROI difference were 0.8 and 0.3. Sensitivity and specificity were 73.7 and 81.8% for ROI ratio, and 70.0 and 81.3% for ROI difference. Area under the curves (AUCs) for ROI ratio and ROI difference were 0.80 [95% confidence interval (CI) 0.67-0.92] and 0.78 (95% CI 0.64-0.92), respectively. CONCLUSION: Quantification of echogenic changes by converting absolute values of tumor and fat regions can predict pCR and individual differences between tumors after NAC in patients with TNBC.
INTRODUCTION: Ultrasound (US) is conventionally performed to determine effects of neoadjuvant chemotherapy (NAC) on breast cancer. In patients with triple-negative breast cancer (TNBC), higher pathological complete response (pCR) predicts the most favorable survival outcome. We aimed to predict pCR to NAC using echogenicity changes in US region of interest (ROI) in patients with TNBC. METHODS AND MATERIALS: We retrospectively determined clinicopathological characteristics of 52 patients with primary TNBC who underwent NAC. Changes in echogenicity for pCR and non-pCR patients were calculated from ratios of tumor to fat (T/F) in their ROIs, before and after NAC, as [T/F After/T/F Before] and [T/F After - T/F Before]. RESULTS: Of the 52 patients (median age: 52 years; range 26-77 years), 20 (38.5%) achieved pCR, which was significantly associated with change in ROI ratio (P < 0.01). The cut-off values for ROI ratio and ROI difference were 0.8 and 0.3. Sensitivity and specificity were 73.7 and 81.8% for ROI ratio, and 70.0 and 81.3% for ROI difference. Area under the curves (AUCs) for ROI ratio and ROI difference were 0.80 [95% confidence interval (CI) 0.67-0.92] and 0.78 (95% CI 0.64-0.92), respectively. CONCLUSION: Quantification of echogenic changes by converting absolute values of tumor and fat regions can predict pCR and individual differences between tumors after NAC in patients with TNBC.
Authors: Quing Zhu; Foluso O Ademuyiwa; Catherine Young; Catherine Appleton; Matthew F Covington; Cynthia Ma; Souzan Sanati; Ian S Hagemann; Atahar Mostafa; K M Shihab Uddin; Isabella Grigsby; Ashley E Frith; Leonel F Hernandez-Aya; Steven S Poplack Journal: Breast Cancer Res Treat Date: 2021-05-10 Impact factor: 4.872
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