Reliability of Magseed® marking before neoadjuvant systemic therapy with subsequent contrast-enhanced mammography in patients with non-palpable breast cancer lesions after treatment: the MAGMA study.

IF 3 3区医学 Q2 ONCOLOGY

Breast Cancer Research and Treatment Pub Date : 2024-11-01 Epub Date: 2024-06-20 DOI:10.1007/s10549-024-07407-6

Eva Iglesias Bravo, Antonio Mariscal Martínez, Helena Peris Alvà, Diego Riol Sancho, José Carlos Antela López, Joel Aranda Sánchez, Pilar Escobar Casa, Cristina Gómez de Las Heras, María Antonia Fernández Venegas, Eduarda García Vidal, Elisabeth Delgado Begines, Carmen García Mur, Isabel Vicente, Carmen Casamayor, Silvia Cruz, Anabel García Barrado

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引用次数: 0

Abstract

Purpose: To assess the reliability of excising residual breast cancer lesions after neoadjuvant systemic therapy (NAST) using a previously localized paramagnetic seed (Magseed®) and the subsequent use of contrast-enhanced spectral mammography (CESM) to evaluate response.

Methods: Observational, prospective, multicenter study including adult women (> 18 years) with invasive breast carcinoma undergoing NAST between January 2022 and February 2023 with non-palpable tumor lesions at surgery. Radiologists marked tumors with Magseed® during biopsy before NAST, and surgeons excised tumors guided by the Sentimag® magnetometer. CESMs were performed before and after NAST to evaluate tumor response (Response Evaluation Criteria for Solid Tumors [RECIST]). We considered intraoperative, surgical, and CESM-related variables and histological response.

Results: We analyzed 109 patients (median [IQR] age of 55.0 [46.0, 65.0] years). Magseed® was retrieved from breast tumors in all surgeries (100%; 95% CI 95.47-100.0%) with no displacement and was identified by radiology in 106 patients (97.24%), a median (IQR) of 176.5 (150.0, 216.3) days after marking. Most surgeries (94.49%) were conservative; they lasted a median (IQR) of 22.5 (14.75, 40.0) min (95% CI 23.59-30.11 min). Most dissected tumor margins (93.57%) were negative, and few patients (5.51%) needed reintervention. Magseed® was identified using CESM in all patients (100%); RECIST responses correlated with histopathological evaluations of dissected tumors using the Miller-Payne response grade (p < 0.0001) and residual lesion diameter (p < 0.0001). Also 69 patients (63.3%) answered a patient's satisfaction survey and 98.8% of them felt very satisfied with the entire procedure.

Conclusion: Long-term marking of breast cancer lesions with Magseed® is a reliable and feasible method in patients undergoing NAST and may be used with subsequent CESM.

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新辅助系统治疗前的 Magseed® 标记与随后的对比增强乳腺 X 线造影术对治疗后无法触及乳腺癌病灶患者的可靠性：MAGMA 研究。

目的：评估使用先前定位的顺磁种子（Magseed®）进行新辅助系统治疗（NAST）后切除残留乳腺癌病灶的可靠性，以及随后使用对比增强光谱乳腺放射摄影术（CESM）评估反应的可靠性：观察性、前瞻性、多中心研究，包括2022年1月至2023年2月期间接受NAST治疗的浸润性乳腺癌成年女性（大于18岁），手术时肿瘤病灶不可触及。放射科医生在NAST前的活检中用Magseed®标记肿瘤，外科医生在Sentimag®磁力计的引导下切除肿瘤。在 NAST 前后进行 CESM，以评估肿瘤反应（实体瘤反应评估标准 [RECIST]）。我们考虑了术中、手术和 CESM 相关变量以及组织学反应：我们分析了 109 名患者（中位数[IQR]年龄为 55.0 [46.0, 65.0]岁）。在所有手术中（100%；95% CI 95.47-100.0%），Magseed®都能从乳腺肿瘤中取出，且没有移位，106 例患者（97.24%）在标记后中位数（IQR）176.5（150.0，216.3）天通过放射学鉴定。大多数手术（94.49%）是保守性的；手术时间中位数（IQR）为 22.5（14.75, 40.0）分钟（95% CI 23.59-30.11 分钟）。大部分切除的肿瘤边缘（93.57%）是阴性的，只有极少数患者（5.51%）需要重新介入。所有患者（100%）都使用 CESM 对 Magseed® 进行了识别；RECIST 反应与使用 Miller-Payne 反应分级对切除肿瘤进行的组织病理学评估相关（P 结论：Magseed® 是一种可用于乳腺癌病灶标记的长期标记方法：使用 Magseed® 对乳腺癌病灶进行长期标记是一种可靠可行的方法，适用于接受 NAST 的患者，并可与后续的 CESM 一起使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Breast Cancer Research and Treatment 医学-肿瘤学

CiteScore

6.80

自引率

2.60%

发文量

342

审稿时长

1 months

期刊介绍： Breast Cancer Research and Treatment provides the surgeon, radiotherapist, medical oncologist, endocrinologist, epidemiologist, immunologist or cell biologist investigating problems in breast cancer a single forum for communication. The journal creates a "market place" for breast cancer topics which cuts across all the usual lines of disciplines, providing a site for presenting pertinent investigations, and for discussing critical questions relevant to the entire field. It seeks to develop a new focus and new perspectives for all those concerned with breast cancer.