Gaiane M Rauch1, Henry M Kuerer2, Beatriz Adrada3, Lumarie Santiago3, Tanya Moseley3, Rosalind P Candelaria3, Elsa Arribas3, Jia Sun4, Jessica W T Leung3, Savitri Krishnamurthy5, Wei T Yang3. 1. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. gmrauch@mdanderson.org. 2. Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 3. Department of Diagnostic Radiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 4. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 5. Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Abstract
PURPOSE: This study was designed to present the secondary imaging endpoints of the trial for evaluating mammogram (MMG), ultrasound (US) and image guided biopsy (IGBx) assessment of pathologic complete response (pCR) in breast cancer (BC) patients undergoing neoadjuvant chemotherapy (NAC). METHODS: Patients with T1-3, N0-3, M0 triple-negative or HER2-positive BC who received NAC were enrolled in an Institutional Review Board-approved prospective, clinical trial. Patients underwent US and MMG at baseline and after NAC. Images were evaluated for residual abnormality and to determine modality for IGBx [US-guided (USG) or stereotactic guided (SG)]. Fine-needle aspiration and 9-G, vacuum-assisted core biopsy (VACBx) of tumor bed was performed after NAC and was compared with histopathology at surgery. RESULTS: Forty patients were enrolled. Median age was 50.5 (range 26-76) years; median baseline tumor size was 2.4 cm (range 0.8-6.3) and 1 cm (range 0-5.5) after NAC. Nineteen patients had pCR: 6 (32%) had residual Ca2+ presurgery, 5 (26%) residual mass, 1 (5%) mass with calcifications, and 7 (37%) no residual imaging abnormality. Sensitivity, specificity, and accuracy of US, MMG, and IGBx for pCR were 47/95/73%, 53/90/73%, and 100/95/98%, respectively. Twenty-five (63%) patients had SGBx and 15 (37%) had US-guided biopsy (USGBx). Median number of cores was higher with SGBx (12, range 6-14) than with USGBx (8, range 4-12), p < 0.002. Positive predictive value for pCR was significantly higher for SG VACBx than for USG VACBx (100 vs. 60%, p < 0.05). CONCLUSIONS: SG VACBx is the preferred IGBx modality for identifying patients with pCR for trials testing the safety of eliminating surgery.
PURPOSE: This study was designed to present the secondary imaging endpoints of the trial for evaluating mammogram (MMG), ultrasound (US) and image guided biopsy (IGBx) assessment of pathologic complete response (pCR) in breast cancer (BC) patients undergoing neoadjuvant chemotherapy (NAC). METHODS:Patients with T1-3, N0-3, M0 triple-negative or HER2-positive BC who received NAC were enrolled in an Institutional Review Board-approved prospective, clinical trial. Patients underwent US and MMG at baseline and after NAC. Images were evaluated for residual abnormality and to determine modality for IGBx [US-guided (USG) or stereotactic guided (SG)]. Fine-needle aspiration and 9-G, vacuum-assisted core biopsy (VACBx) of tumor bed was performed after NAC and was compared with histopathology at surgery. RESULTS: Forty patients were enrolled. Median age was 50.5 (range 26-76) years; median baseline tumor size was 2.4 cm (range 0.8-6.3) and 1 cm (range 0-5.5) after NAC. Nineteen patients had pCR: 6 (32%) had residual Ca2+ presurgery, 5 (26%) residual mass, 1 (5%) mass with calcifications, and 7 (37%) no residual imaging abnormality. Sensitivity, specificity, and accuracy of US, MMG, and IGBx for pCR were 47/95/73%, 53/90/73%, and 100/95/98%, respectively. Twenty-five (63%) patients had SGBx and 15 (37%) had US-guided biopsy (USGBx). Median number of cores was higher with SGBx (12, range 6-14) than with USGBx (8, range 4-12), p < 0.002. Positive predictive value for pCR was significantly higher for SG VACBx than for USG VACBx (100 vs. 60%, p < 0.05). CONCLUSIONS: SG VACBx is the preferred IGBx modality for identifying patients with pCR for trials testing the safety of eliminating surgery.
Authors: Rosalind P Candelaria; Beatriz E Adrada; Deanna L Lane; Gaiane M Rauch; Stacy L Moulder; Alastair M Thompson; Roland L Bassett; Elsa M Arribas; Huong T Le-Petross; Jessica W T Leung; David A Spak; Elizabeth E Ravenberg; Jason B White; Vicente Valero; Wei T Yang Journal: Ultrasound Med Biol Date: 2022-03-14 Impact factor: 2.998
Authors: Ariane A van Loevezijn; Marieke E M van der Noordaa; Erik D van Werkhoven; Claudette E Loo; Gonneke A O Winter-Warnars; Terry Wiersma; Koen K van de Vijver; Emilie J Groen; Charlotte F J M Blanken-Peeters; Bas J G L Zonneveld; Gabe S Sonke; Frederieke H van Duijnhoven; Marie-Jeanne T F D Vrancken Peeters Journal: Ann Surg Oncol Date: 2020-12-02 Impact factor: 5.344
Authors: Elizabeth J Sutton; Lior Z Braunstein; Mahmoud B El-Tamer; Edi Brogi; Mary Hughes; Yolanda Bryce; Jill S Gluskin; Simon Powell; Alyssa Woosley; Audree Tadros; Varadan Sevilimedu; Danny F Martinez; Larowin Toni; Olga Smelianskaia; C Gregory Nyman; Pedram Razavi; Larry Norton; Maggie M Fung; James D Sedorovich; Virgilio Sacchini; Elizabeth A Morris Journal: JAMA Netw Open Date: 2021-01-04
Authors: Elizabeth J Sutton; Natsuko Onishi; Duc A Fehr; Brittany Z Dashevsky; Meredith Sadinski; Katja Pinker; Danny F Martinez; Edi Brogi; Lior Braunstein; Pedram Razavi; Mahmoud El-Tamer; Virgilio Sacchini; Joseph O Deasy; Elizabeth A Morris; Harini Veeraraghavan Journal: Breast Cancer Res Date: 2020-05-28 Impact factor: 6.466