Maki Namura1, Hiroko Tsunoda2, Hiroshi Yagata3, Naoki Hayashi4, Atsushi Yoshida4, Emiko Morishita2, Junko Takei4, Koyu Suzuki5, Hideko Yamauchi4. 1. Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan. Electronic address: namumaki@gmail.com. 2. Department of Radiology, St. Luke's International Hospital, Tokyo, Japan. 3. Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan; Department of Breast Care, Saitama Medical Center, Saitama Medical University, Saitama, Japan. 4. Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan. 5. Department of Pathology, St. Luke's International Hospital, Tokyo, Japan.
Abstract
INTRODUCTION: The influence of breast cancer (BC) subtype in discrepancies between pathologic complete response (pCR) and complete response by magnetic resonance imaging (MRI-CR) after neoadjuvant chemotherapy (NAC) have not been discussed well. We evaluated the association between BC subtype and pCR or only residual in situ lesion without invasive cancer (pCR/in situ+) in patients with MRI-CR (positive predictive value [PPV]). MATERIAL AND METHODS: From the data of 716 patients with primary BC who were diagnosed with invasive cancer and treated with NAC and then surgery from January 2009 to May 2014 at St. Luke's International Hospital, 180 patients were determined to have MRI-CR by retrospective chart review. BC subtypes at baseline were classified into 6 subtypes, as strong estrogen receptor (ER++), moderately positive ER (ER+), negative ER (ER-), and HER2 status expression. RESULTS: Three subtypes had PPV (pCR) ≥ 50%: ER-/HER2+ (56.3%, 27/48), ER-/HER2- (57.6%, 34/59), and ER+/HER2+ (56.2%, 9/16). However, PPV (pCR) for the ER++/HER2- and ER++/HER2+ subtypes was < 30%; notably, only 12.0% (3/25) for the ER++/HER2- subtype, which was significantly low (P < .001) compared with ER++/HER2- and other subtypes. PPV (pCR/in situ+) was significantly low at 20.0% in the ER++/HER2- subtype (P < .001 compared with other subtypes). PPV (pCR/in situ+) in other subtypes was collectively greater than 60%, and was 91.7% in the ER-/HER2+ subtype. CONCLUSION: We should interpret carefully MRI-CR of NAC to evaluate residual disease for ER++/HER2- BC.
INTRODUCTION: The influence of breast cancer (BC) subtype in discrepancies between pathologic complete response (pCR) and complete response by magnetic resonance imaging (MRI-CR) after neoadjuvant chemotherapy (NAC) have not been discussed well. We evaluated the association between BC subtype and pCR or only residual in situ lesion without invasive cancer (pCR/in situ+) in patients with MRI-CR (positive predictive value [PPV]). MATERIAL AND METHODS: From the data of 716 patients with primary BC who were diagnosed with invasive cancer and treated with NAC and then surgery from January 2009 to May 2014 at St. Luke's International Hospital, 180 patients were determined to have MRI-CR by retrospective chart review. BC subtypes at baseline were classified into 6 subtypes, as strong estrogen receptor (ER++), moderately positive ER (ER+), negative ER (ER-), and HER2 status expression. RESULTS: Three subtypes had PPV (pCR) ≥ 50%: ER-/HER2+ (56.3%, 27/48), ER-/HER2- (57.6%, 34/59), and ER+/HER2+ (56.2%, 9/16). However, PPV (pCR) for the ER++/HER2- and ER++/HER2+ subtypes was < 30%; notably, only 12.0% (3/25) for the ER++/HER2- subtype, which was significantly low (P < .001) compared with ER++/HER2- and other subtypes. PPV (pCR/in situ+) was significantly low at 20.0% in the ER++/HER2- subtype (P < .001 compared with other subtypes). PPV (pCR/in situ+) in other subtypes was collectively greater than 60%, and was 91.7% in the ER-/HER2+ subtype. CONCLUSION: We should interpret carefully MRI-CR of NAC to evaluate residual disease for ER++/HER2- BC.
Authors: Simon Peter Gampenrieder; Andreas Peer; Christian Weismann; Matthias Meissnitzer; Gabriel Rinnerthaler; Johanna Webhofer; Theresa Westphal; Marina Riedmann; Thomas Meissnitzer; Heike Egger; Frederike Klaassen Federspiel; Roland Reitsamer; Cornelia Hauser-Kronberger; Katharina Stering; Klaus Hergan; Brigitte Mlineritsch; Richard Greil Journal: Breast Cancer Res Date: 2019-01-31 Impact factor: 6.466