The accuracy of MRI in detecting pathological complete response following neoadjuvant chemotherapy in different breast cancer subtypes

IF 2.3 4区医学 Q3 ONCOLOGY

Surgical Oncology-Oxford Pub Date : 2023-10-31 DOI:10.1016/j.suronc.2023.102011

Miroslava Kuzmova, Carolyn Cullinane, Claire Rutherford, Damian McCartan, Jane Rothwell, Denis Evoy, James Geraghty, Ruth S. Prichard

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引用次数: 0

Abstract

Background

Pathological complete response (pCR) following neo-adjuvant chemotherapy (NACT) for breast cancer is associated with improved disease-free and overall survival in certain breast cancer subtypes. Magnetic Resonance Imaging (MRI) is increasingly used as standard to assess treatment response in patients receiving NACT. The aim of this study was to determine the clinical utility of MRI in accurately predicting pCR post-NACT.

Methods

A single-centre, retrospective study was conducted in breast cancer patients, who received NACT between 2013 and 2020. Patients who had an MRI before and after NACT were included. Pathological and MRI radiological response rates to NACT were analyzed and MRI accuracy assessed in detecting pCR according to breast cancer subtype.

Results

One hundred and sixty-seven patients were included in the study. Forty-one of the 167 patients achieved pCR (24.6 %), with the highest proportion in HR- HER2+ subgroup (58.3 %), followed by triple negative breast cancer (TNBC) (35 %). Only 22.2 % and 10.5 % of patients with HR + HER2+ and HR + HER2-respectively achieved pCR. The overall accuracy of MRI in predicting pCR after NACT was 77.3 %. The greatest accuracy was in TNBC (87.5 %) with a specificity and positive predictive value (PPV) of 100 % and the highest number of correctly diagnosed complete responses (14 of 40). MRI was less accurate in predicting response rates in HR + HER2- (PPV 91.2 %) and HR + HER2+ groups (PPV 90.5 %). MRI performed significantly better in predicting complete response in TNBC compared to HR + HER2-subtype (p = 0.0057).

Conclusion

MRI is a clinically useful adjunct in assessing pCR following NACT and appears to predict pathological response more accurately in TNBC compared to HR + HER2-breast cancer subtypes. This has significant clinical implications in terms of surgical planning, adjuvant treatment options and prognosis.

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MRI检测不同类型癌症新辅助化疗后病理完全反应的准确性。

背景：癌症新辅助化疗（NACT）后的病理完全反应（pCR）与某些癌症亚型的无病和总生存率提高有关。磁共振成像（MRI）越来越多地被用作评估接受NACT的患者的治疗反应的标准。本研究的目的是确定MRI在准确预测NACT后pCR方面的临床实用性。方法：对2013年至2020年间接受NACT治疗的癌症患者进行单中心回顾性研究。包括NACT前后进行MRI检查的患者。分析NACT的病理和MRI放射性反应率，并根据癌症亚型评估MRI检测pCR的准确性。结果：167名患者被纳入研究。167名患者中有41名患者实现了pCR（24.6%），其中HR-HER2+亚组的比例最高（58.3%），其次是三阴性癌症（TNBC）（35%）。HR+HER2+和HR+HER2患者中分别只有22.2%和10.5%达到pCR。MRI预测NACT后pCR的总体准确率为77.3%。TNBC的准确率最高（87.5%），特异性和阳性预测值（PPV）为100%，正确诊断的完全缓解次数最高（40次中有14次）。MRI在预测HR+HER2-（PPV 91.2%）和HR+HER2+组（PPV 90.5%）的应答率方面不太准确。与HR+HER2亚型相比，MRI在预测TNBC的完全应答方面表现得更好（p=0.0057）至HR+HER2-乳腺癌症亚型。这在手术计划、辅助治疗选择和预后方面具有重要的临床意义。

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

Surgical Oncology-Oxford 医学-外科

CiteScore

4.50

自引率

0.00%

发文量

169

审稿时长

38 days

期刊介绍： Surgical Oncology is a peer reviewed journal publishing review articles that contribute to the advancement of knowledge in surgical oncology and related fields of interest. Articles represent a spectrum of current technology in oncology research as well as those concerning clinical trials, surgical technique, methods of investigation and patient evaluation. Surgical Oncology publishes comprehensive Reviews that examine individual topics in considerable detail, in addition to editorials and commentaries which focus on selected papers. The journal also publishes special issues which explore topics of interest to surgical oncologists in great detail - outlining recent advancements and providing readers with the most up to date information.