Accuracy of Ultrasonography and Mammography in Predicting Pathologic Response After Neoadjuvant Chemotherapy for Breast Cancer

Overview

Journal Am J Surg

Specialty General Surgery

Date 2010 Apr 3

PMID 20359567

Citations 44

Authors

Jason D Keune

Donna B Jeffe

Mario Schootman

Abigail Hoffman

William E Gillanders

Rebecca L Aft

Affiliations

Soon will be listed here.

Abstract

Background: Neoadjuvant chemotherapy reduces tumor size before surgery in women with breast cancer. The aim of this study was to assess the ability of mammography and ultrasound to predict residual tumor size following neoadjuvant chemotherapy.

Methods: In a retrospective review of consecutive breast cancer patients treated with neoadjuvant chemotherapy, residual tumor size estimated by diagnostic imaging was compared with residual tumor size determined by surgical pathology.

Results: One hundred ninety-two patients with 196 primary breast cancers were studied. Of 104 tumors evaluated by both imaging modalities, ultrasound was able to size 91.3%, and mammography was able to size only 51.9% (chi(2)P < .001). Ultrasound also was more accurate than mammography in estimating residual tumor size (62 of 104 [59.6%] vs 33 of 104 [31.7%], P < .001). There was little difference in the ability of mammography and ultrasound to predict pathologic complete response (receiver operating characteristic, 0.741 vs 0.784).

Conclusions: Breast ultrasound was more accurate than mammography in predicting residual tumor size following neoadjuvant chemotherapy. The likelihood of a complete pathologic response was 80% when both imaging modalities demonstrated no residual disease.

Citing Articles

A deep learning approach for early prediction of breast cancer neoadjuvant chemotherapy response on multistage bimodal ultrasound images.

Xie J, Wei J, Shi H, Lin Z, Lu J, Zhang X BMC Med Imaging. 2025; 25(1):26.

PMID: 39849366 PMC: 11758756. DOI: 10.1186/s12880-024-01543-7.

Dynamic ultrasound-based modeling predictive of response to neoadjuvant chemotherapy in patients with early breast cancer.

Wang X, Zhang Y, Yang M, Wu N, Wang S, Chen H Sci Rep. 2024; 14(1):31644.

PMID: 39738182 PMC: 11685924. DOI: 10.1038/s41598-024-80409-y.

Model based on ultrasound and clinicopathological characteristics for early prediction of pathological complete response to neoadjuvant chemotherapy in breast cancer.

Wen X, Chen J, Zhong J, Zhuang Y, Deng B, Lin Y Quant Imaging Med Surg. 2024; 14(12):8840-8851.

PMID: 39698713 PMC: 11652014. DOI: 10.21037/qims-24-1268.

Unlocking Chemotherapy Success: The Role of Diffusion Tensor Imaging in Breast Cancer Treatment.

Ciurea A, Bene I, Cheregi P, Brad T, Ciortea C, Rusu G Diagnostics (Basel). 2024; 14(23).

PMID: 39682558 PMC: 11639939. DOI: 10.3390/diagnostics14232650.

Amplitude-Modulation Frequency Optimization for Enhancing Harmonic Motion Imaging Performance of Breast Tumors in the Clinic.

Liu Y, Hossain M, Li X, Konofagou E Ultrasound Med Biol. 2024; 51(1):169-179.

PMID: 39428259 PMC: 11758706. DOI: 10.1016/j.ultrasmedbio.2024.09.021.

References

Moneer M, Khaled H, Makarem S . Pathological assessment of the response of locally advanced breast cancer to neoadjuvant chemotherapy and its implications for surgical management. Surg Today. 2001; 30(3):249-54. DOI: 10.1007/s005950050054. View

Buchholz T, Tucker S, Masullo L, Kuerer H, Erwin J, Salas J . Predictors of local-regional recurrence after neoadjuvant chemotherapy and mastectomy without radiation. J Clin Oncol. 2002; 20(1):17-23. DOI: 10.1200/JCO.2002.20.1.17. View

Londero V, Bazzocchi M, Del Frate C, Puglisi F, Di Loreto C, Francescutti G . Locally advanced breast cancer: comparison of mammography, sonography and MR imaging in evaluation of residual disease in women receiving neoadjuvant chemotherapy. Eur Radiol. 2004; 14(8):1371-9. DOI: 10.1007/s00330-004-2246-z. View

Rosen E, Blackwell K, Baker J, Soo M, Bentley R, Yu D . Accuracy of MRI in the detection of residual breast cancer after neoadjuvant chemotherapy. AJR Am J Roentgenol. 2003; 181(5):1275-82. DOI: 10.2214/ajr.181.5.1811275. View

Sinn H, Schmid H, Junkermann H, Huober J, Leppien G, Kaufmann M . [Histologic regression of breast cancer after primary (neoadjuvant) chemotherapy]. Geburtshilfe Frauenheilkd. 1994; 54(10):552-8. DOI: 10.1055/s-2007-1022338. View

Pain J, Ebbs S, Hern R, Lowe S, Bradbeer J . Assessment of breast cancer size: a comparison of methods. Eur J Surg Oncol. 1992; 18(1):44-8. View

Forouhi P, Walsh J, Anderson T, Chetty U . Ultrasonography as a method of measuring breast tumour size and monitoring response to primary systemic treatment. Br J Surg. 1994; 81(2):223-5. DOI: 10.1002/bjs.1800810221. View

Sauven P . The surgical management of patients following neoadjuvant chemotherapy for locally advanced breast cancer. Eur J Cancer. 2002; 38(18):2371-4. DOI: 10.1016/s0959-8049(02)00243-5. View

Warren R, Bobrow L, Earl H, Britton P, Gopalan D, Purushotham A . Can breast MRI help in the management of women with breast cancer treated by neoadjuvant chemotherapy?. Br J Cancer. 2004; 90(7):1349-60. PMC: 2409692. DOI: 10.1038/sj.bjc.6601710. View

10.

Rouzier R, Mathieu M, Sideris L, Youmsi E, Rajan R, Garbay J . Breast-conserving surgery after neoadjuvant anthracycline-based chemotherapy for large breast tumors. Cancer. 2004; 101(5):918-25. DOI: 10.1002/cncr.20491. View

11.

Wolff A, Davidson N . Primary systemic therapy in operable breast cancer. J Clin Oncol. 2000; 18(7):1558-69. DOI: 10.1200/JCO.2000.18.7.1558. View

12.

Esserman L, Hylton N, Yassa L, Barclay J, Frankel S, Sickles E . Utility of magnetic resonance imaging in the management of breast cancer: evidence for improved preoperative staging. J Clin Oncol. 1999; 17(1):110-9. DOI: 10.1200/JCO.1999.17.1.110. View

13.

Kuerer H, Newman L, Smith T, Ames F, Hunt K, Dhingra K . Clinical course of breast cancer patients with complete pathologic primary tumor and axillary lymph node response to doxorubicin-based neoadjuvant chemotherapy. J Clin Oncol. 1999; 17(2):460-9. DOI: 10.1200/JCO.1999.17.2.460. View

14.

Akazawa K, Tamaki Y, Taguchi T, Tanji Y, Miyoshi Y, Kim S . Preoperative evaluation of residual tumor extent by three-dimensional magnetic resonance imaging in breast cancer patients treated with neoadjuvant chemotherapy. Breast J. 2006; 12(2):130-7. DOI: 10.1111/j.1075-122X.2006.00220.x. View

15.

Huber S, Medl M, Vesely M, Czembirek H, Zuna I, Delorme S . Ultrasonographic tissue characterization in monitoring tumor response to neoadjuvant chemotherapy in locally advanced breast cancer (work in progress). J Ultrasound Med. 2000; 19(10):677-86. DOI: 10.7863/jum.2000.19.10.677. View

16.

Denis F, Desbiez-Bourcier A, Chapiron C, Arbion F, Body G, Brunereau L . Contrast enhanced magnetic resonance imaging underestimates residual disease following neoadjuvant docetaxel based chemotherapy for breast cancer. Eur J Surg Oncol. 2004; 30(10):1069-76. DOI: 10.1016/j.ejso.2004.07.024. View

17.

Moneer M, El-Didi M, Khaled H . Breast conservative surgery: is it appropriate for locally advanced breast cancer following downstaging by neoadjuvant chemotherapy? A pathological assessment. Breast. 2004; 8(6):315-9. DOI: 10.1054/brst.1999.0079. View

18.

Helvie M, Joynt L, Cody R, Pierce L, Adler D, Merajver S . Locally advanced breast carcinoma: accuracy of mammography versus clinical examination in the prediction of residual disease after chemotherapy. Radiology. 1996; 198(2):327-32. DOI: 10.1148/radiology.198.2.8596826. View

19.

Kald B, Boiesen P, Ronnow K, Jonsson P, Bisgaard T . Preoperative assessment of small tumours in women with breast cancer. Scand J Surg. 2005; 94(1):15-20. DOI: 10.1177/145749690509400105. View

20.

van der Hage J, van de Velde C, Julien J, Tubiana-Hulin M, Vandervelden C, Duchateau L . Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902. J Clin Oncol. 2001; 19(22):4224-37. DOI: 10.1200/JCO.2001.19.22.4224. View