Comparison of mammography, sonography, MRI and clinical examination in patients with locally advanced or inflammatory breast cancer who underwent neoadjuvant chemotherapy

Abstract

Objectives: The purpose of this study was to determine the relative accuracies of mammography, sonography, MRI and clinical examination in predicting residual tumour size and pathological response after neoadjuvant chemotherapy for locally advanced or inflammatory breast cancer. Each prediction method was compared with the gold standard of surgical pathology. Methods: 43 patients (age range, 25-62 years; mean age, 42.7 years) with locally advanced or inflammatory breast cancer who had been treated by neoadjuvant chemotherapy were enrolled prospectively. We compared the predicted residual tumour size and the predicted response on imaging and clinical examination with residual tumour size and response on pathology. Statistical analysis was performed using weighted kappa statistics and intraclass correlation coefficients (ICC). Conclusion:Predictions of response and residual tumour size made on MRI were better correlated with the assessments of response and residual tumour size made upon pathology than were predictions made on the basis of clinical examination, mammography or sonography. Thus, the evaluation of predicted response using MRI could provide a relatively sensitive early assessment of chemotherapy efficacy.

Correlation of Pathological Complete Response with Radiological Evaluation after Neoadjuvant Chemotherapy of Breast Carcinoma

“…Dense breast tissue and the infiltrating nature of the growth of locally advanced or inflammatory breast cancer are two major factors that might make it difficult to evaluate exact tumor size and response rate after neoadjuvant chemotherapy on mammography [14]. Dense breast tissue often obscures the tumor margin on mammography, thus making size determination difficult.…”

“…In this study we explored the sensitivity of radiological modalities to accurately determine pathologic complete response in the breast after NAC. In previous studies, correlation with the pathologically assessed residual tumor size ranged from 0.42 to 0.68 for tumor sizes assessed by clinical examination, from 0.33 to 0.84 for tumor sizes assessed by mammography and from 0.29 to 0.89 for tumor sizes assessed by sonography [13].Dense breast tissue and the infiltrating nature of the growth of locally advanced or inflammatory breast cancer are two major factors that might make it difficult to evaluate exact tumor size and response rate after neoadjuvant chemotherapy on mammography [14]. Dense breast tissue often obscures the tumor margin on mammography, thus making size determination difficult.…”

Inflammatory Breast Neoplasms: A Systematic Review

“…Several studies investigated diagnosis and treatment 4,10,[12][13][14][15][16][17][18][19]21,23,26,28 , two of which 10,15 show that MRI (Magnetic Resonance Imaging) is significantly more accuracy for diagnosing IBC. LePetross 9 argues that MRI has a 98% accuracy rate in targeting IBC when compared with ultrasonic imaging (94%) and a mammogram (65%).…”

1830 Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques

“…Up to now, prediction of pCR, that is, diagnosing a pCR without surgery, is based on tumour biology at diagnosis, the applied NACT regimen and breast imaging results; all with mediocre accuracy (Gianni et al, 2005;Chagpar et al, 2006;Goldstein et al, 2007;Tiezzi et al, 2007;Shin et al, 2011). Tumour biology has already demonstrated to predict pCR to some extent; for example, triple negative breast cancers (TNBC) show pCR rates of up to 64% (von Minckwitz et al, 2014b) and for HER2 þ tumours pCR rates of up to 66% (Schneeweiss et al, 2013), but much lower pCR rates in luminal-type-like tumours (von Minckwitz et al, 2012).…”