e11507 Background: It is reported that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) may have the potential of predicting response to neoadjuvant chemotherapy (NAC) for patients with breast cancer and it is more accurate than the other radiologic methods. We aimed to compare the responses to NAC ± trastuzumab with DCE-MRI and histopathologic findings in locally advanced breast cancer. Methods: Between January 2007 and October 2011, 38 female patients patients with locally advanced breast cancer who recieved NAC ± trastuzumab and had whole breast DCE-MRI before / after treatment and who also had surgery after treatment were included in our study. Patients received 4 cycles of antracyclin based and 4 cycles of taxane based chemotherapy protocols sequentially. 9 patients with HER-2 (+) breast cancer also received trastuzumab with taxane based chemotherapy. Before and after NAC ± trastuzumab, tumor measurements were evaluated by mammography (MG), ultrasound (US), DCE-MRI and compared with postoperative histopathologic findings. Response rates were assessed with RECIST (Response Evolution Criteria in Solid Tumors) 1,1 criteria. MRI were done with 1,5 Tesla MR ( Gyroscan Achieva Intera, Philips ). SPSS 15.0 and Kappa test were used for statistical analysis. Results: After NAC ± trastuzumab, breast DCE-MRI revealed 13.2% complete response (CR), 73.7% partial response (PR), 10.5% stabile disease (SD), and 2.6% progressive disease (PD) and 15.8% CR, 73.7% PR, 7.9% SD and 2.6% PD were shown with histopathology. After neoadjuvant systemic treatment, histopathologic and DCE-MRI responses revealed high positive correlation with kappa test (kappa: 0,63), but there were low correlation between not only histopathologic and MG responses but also US responses with kappa test (kappa: 0,2). Conclusions: DCE-MRI is more effective method than other radiologic methods for the evaluation of response to NAC ± trastuzumab when compared with the histopathologic findings.
One of the key issues during adjuvant treatments is ensuring that patients have a worthwhile health-related quality of life (HRQOL). We compared short-term HRQOL in Turkish patients with operable breast cancer receiving EC or FEC as adjuvant chemotherapy. Eligible patients (n=60) with Stage I-II and Stage III breast cancer were assigned to EC (Group I) and FEC (Group II), respectively. HRQOL was assessed with WHOQOL-BREF-TR, Beck Depression Inventory and State-Trait Anxiety Inventory at baseline and the start of cycles 2, 4 and 3 months after the last cycle. More patients with advanced stage (operable stage III) (n=26, 86.7%) and MRM (n=18, 60%) were treated with FEC (p<0.001 and p= 0.07, respectively). There were no statistically significant differences in global HRQOL between the two treatment groups. However, the comparison of the depression scores revealed an increase in Group II (p=0.002). Information about the expected HRQOL and psychological consequences of treatment regimens should help clinicians and their patients make informed treatment decisions.[Turk
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