Monika Graeser1,2,3, Simone Schrading4, Oleg Gluz5,6,7, Kevin Strobel4, Christopher Herzog8, Lale Umutlu9, Alex Frydrychowicz10, Dorothea Rjosk-Dendorfer11, Rachel Würstlein5,12, Ralph Culemann13, Christine Eulenburg5, Jascha Adams14, Henrik Nitzsche6, Anna Prange15, Sherko Kümmel5,16,17, Eva-Maria Grischke18, Helmut Forstbauer19, Michael Braun20, Jochem Potenberg21, Raquel von Schumann6, Bahriye Aktas22,23, Cornelia Kolberg-Liedtke17,22, Nadia Harbeck5,12, Christiane K Kuhl4, Ulrike Nitz5,6. 1. West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany. monika.graeser@wsg-online.com. 2. Ev. Hospital Bethesda, Breast Center Niederrhein, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany. monika.graeser@wsg-online.com. 3. Department of Gynecology, University Medical Center Hamburg, Martinistrasse 52, 20251, Hamburg, Germany. monika.graeser@wsg-online.com. 4. Department of Diagnostic and Interventional Radiology, Hospital of the University of Aachen, RWTH, Pauwelsstrasse 30, 52074, Aachen, Germany. 5. West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany. 6. Ev. Hospital Bethesda, Breast Center Niederrhein, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany. 7. University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany. 8. Radiology, Burgstrasse 7, 80331, Munich, Germany. 9. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. 10. Department of Radiology and Nuclear Medicine, Schleswig-Holstein University Hospital, Campus Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany. 11. Department of Radiology, University Hospital, LMU Munich, Marchioninistrasse. 15, 81377, Munich, Germany. 12. Department of Gynecology and Obstetrics, Breast Center, University of Munich (LMU) and CCCLMU, Marchioninistrasse 15, 81377, Munich, Germany. 13. Medizinisches Versorgungszentrum Radiologie Rhein-Sieg, GFO Kliniken Troisdorf, Hospitalstrasse 45, 53840, Troisdorf, Germany. 14. Alcedis GmbH, Winchesterstrasse 3, 35394, Giessen, Germany. 15. Department of Radiology, Clinics Essen-Mitte, Breast Centre, Henricistrasse 92, 45136, Essen, Germany. 16. Clinics Essen-Mitte, Breast Centre, Henricistrasse 92, 45136, Essen, Germany. 17. University Hospital Charité, Women's Clinic, Berlin, Charitéplatz 1, 10117, Berlin, Germany. 18. University Clinic Tuebingen, Women's Clinic, Calwerstrasse 7, 72076, Tuebingen, Germany. 19. Practice Network Troisdorf, Schlossstrasse 18, 53840, Troisdorf, Germany. 20. Red Cross Women's Hospital, Nymphenburger Strasse 163, 80634, Munich, Germany. 21. Ev. Waldkrankenhaus Berlin, Stadtrandstrasse 555, 13589, Berlin, Germany. 22. Department of Gynecology and Obstetrics, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany. 23. Department of Gynecology, University Hospital Leipzig, Liebeigstrasse 20A, 04103, Leipzig, Germany.
Abstract
BACKGROUND: Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes. METHODS: Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values. RESULTS: A total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by < 10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, NPV (proportion of correctly predicted tumor size ≤10 mm) of MRI and ultrasound was 0.92 and 0.83; PPV (correctly predicted tumor size > 10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR-/HER2+ tumors. Both methods had a comparable NPV and PPV in HR-/HER2- tumors. CONCLUSIONS: In HR+/HER2+ and HR-/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT. TRIAL REGISTRATION: Clinicaltrials.gov , NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).
BACKGROUND: Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes. METHODS: Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values. RESULTS: A total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by < 10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, NPV (proportion of correctly predicted tumor size ≤10 mm) of MRI and ultrasound was 0.92 and 0.83; PPV (correctly predicted tumor size > 10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR-/HER2+ tumors. Both methods had a comparable NPV and PPV in HR-/HER2- tumors. CONCLUSIONS: In HR+/HER2+ and HR-/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT. TRIAL REGISTRATION: Clinicaltrials.gov , NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).
Entities:
Keywords:
Breast cancer; Magnetic resonance imaging; Neoadjuvant therapy; Residual tumor size; Ultrasound
Authors: Eren Yeh; Priscilla Slanetz; Daniel B Kopans; Elizabeth Rafferty; Dianne Georgian-Smith; Linda Moy; Elkan Halpern; Richard Moore; Irene Kuter; Alphonse Taghian Journal: AJR Am J Roentgenol Date: 2005-03 Impact factor: 3.959
Authors: Oleg Gluz; Ulrike Nitz; Cornelia Liedtke; Matthias Christgen; Eva-Maria Grischke; Helmut Forstbauer; Michael Braun; Mathias Warm; John Hackmann; Christoph Uleer; Bahriye Aktas; Claudia Schumacher; Nikola Bangemann; Christoph Lindner; Sherko Kuemmel; Michael Clemens; Jochem Potenberg; Peter Staib; Andreas Kohls; Raquel von Schumann; Ronald Kates; Ronald Kates; Johannes Schumacher; Rachel Wuerstlein; Hans Heinrich Kreipe; Nadia Harbeck Journal: J Natl Cancer Inst Date: 2018-06-01 Impact factor: 13.506
Authors: Davendra Segara; Ian E Krop; Judy E Garber; Eric Winer; Lyndsay Harris; Jennifer R Bellon; Robyn Birdwell; Susan Lester; Stuart Lipsitz; J Dirk Iglehart; Mehra Golshan Journal: J Surg Oncol Date: 2007-11-01 Impact factor: 3.454
Authors: U A Nitz; O Gluz; M Christgen; E-M Grischke; D Augustin; S Kuemmel; M Braun; J Potenberg; A Kohls; K Krauss; A Stefek; C Schumacher; H Forstbauer; T Reimer; H Fischer; C Liedtke; R Wuerstlein; J Schumacher; R Kates; H Kreipe; N Harbeck Journal: Ann Oncol Date: 2017-11-01 Impact factor: 32.976
Authors: Daniel Hofmann; Ulrike Nitz; Oleg Gluz; Ronald E Kates; Timo Schinkoethe; Peter Staib; Nadia Harbeck Journal: Trials Date: 2013-08-19 Impact factor: 2.279
Authors: M B I Lobbes; R Prevos; M Smidt; V C G Tjan-Heijnen; M van Goethem; R Schipper; R G Beets-Tan; J E Wildberger Journal: Insights Imaging Date: 2013-01-29
Authors: Michael L Marinovich; Petra Macaskill; Les Irwig; Francesco Sardanelli; Eleftherios Mamounas; Gunter von Minckwitz; Valentina Guarneri; Savannah C Partridge; Frances C Wright; Jae Hyuck Choi; Madhumita Bhattacharyya; Laura Martincich; Eren Yeh; Viviana Londero; Nehmat Houssami Journal: BMC Cancer Date: 2015-10-08 Impact factor: 4.430
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