Giorgia Pasquero1, Alessandra Surace2, Antonio Ponti3, Massimiliano Bortolini4, Donatella Tota5, Maria Piera Mano3, Riccardo Arisio6, Chiara Benedetto1, Maria Grazia Baù7. 1. Gynecology and Obstetrics 1, Department of Surgical Sciences, City of Health and Science, University of Turin, Turin, Italy. 2. Gynecology and Obstetrics 2, Department of Surgical Sciences, City of Health and Science, University of Turin, Turin, Italy alessandra.sur@gmail.com. 3. AOU Città della Salute e della Scienza, CPO Piemonte and EUSOMA Data Centre, Turin, Italy. 4. Breast Unit Surgery, Martini Hospital, Turin, Italy. 5. Radiology, Department of Diagnostic Imaging and Radiotherapy, City of Health and Science, University of Turin, Turin, Italy. 6. Pathology, Department of Laboratory Medicine, City of Health and Science, University of Turin, Turin, Italy. 7. Gynecology and Obstetrics 3, Department of Surgical Sciences, City of Health and Science, University of Turin, Turin, Italy.
Abstract
BACKGROUND/AIM: The aim of the study was to evaluate whether residual tumor assessment by magnetic resonance imaging (MRI) after neoadjuvant chemotherapy (NACT) is fundamental for a successive surgical strategy. PATIENTS AND METHODS: We collected 55 MRIs performed after NACT. RESULTS: Pathological response rate was 20%. MRI's sensitivity, specificity, PPV and NPV were 50%, 88%, 54% and 86%, respectively. We observed a high variability between the different subgroups, with high number of false positives in luminal A/B tumors. Triple negative and HER2+ tumors had almost the same specificity and sensitivity (81% and 50%). Nevertheless, in the HER2+ group, PPV was greater than that in the triple negative group (71% and 33% respectively) and the NPV of the triple negative group was greater than that of the HER2+ one (90% and 64%, respectively). Statistical analysis showed a weak but significant correlation between MRI and pathological assessment of residual tumor dimension. CONCLUSION: The present study, confirms literature data about MRI accuracy in diagnosing HER2+ and triple negative tumors, but suggests caution in case of luminal tumors' evaluation. Copyright
BACKGROUND/AIM: The aim of the study was to evaluate whether residual tumor assessment by magnetic resonance imaging (MRI) after neoadjuvant chemotherapy (NACT) is fundamental for a successive surgical strategy. PATIENTS AND METHODS: We collected 55 MRIs performed after NACT. RESULTS: Pathological response rate was 20%. MRI's sensitivity, specificity, PPV and NPV were 50%, 88%, 54% and 86%, respectively. We observed a high variability between the different subgroups, with high number of false positives in luminal A/B tumors. Triple negative and HER2+ tumors had almost the same specificity and sensitivity (81% and 50%). Nevertheless, in the HER2+ group, PPV was greater than that in the triple negative group (71% and 33% respectively) and the NPV of the triple negative group was greater than that of the HER2+ one (90% and 64%, respectively). Statistical analysis showed a weak but significant correlation between MRI and pathological assessment of residual tumor dimension. CONCLUSION: The present study, confirms literature data about MRI accuracy in diagnosing HER2+ and triple negative tumors, but suggests caution in case of luminal tumors' evaluation. Copyright
Keywords:
Magnetic resonance imaging; breast cancer subtypes; breast neoplasms; imaging complete response (iCR); neoadjuvant chemotherapy; pathological complete response (pCR)
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