Mammographic breast density: Predictive value for pathological response to neoadjuvant chemotherapy in breast cancer patients

Elsamany, Shereef; Al-Zahrani, Abdullah S.; Abozeed, Waleed; Rasmy, Ayman; Farooq, Mian Usman; Elbiomy, Mahmoud; Rawah, Elham; Alsaleh, Khalid; Abdel-Aziz, Nashwa

doi:10.1016/j.breast.2015.05.007

Cited by 31 publications

(26 citation statements)

References 33 publications

(36 reference statements)

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“…Differences were largest among postmenopausal and HR− patients [36]. Several other studies have associated lower BMI with higher rates of pCR [37]. Weight gain during neoadjuvant chemotherapy has not been associated with pCR [38], except perhaps in subgroups of women who were normal/underweight or postmenopausal at baseline, where it was associated with higher pCR rates [39].…”

Section: Discussionmentioning

confidence: 99%

Impact of race, ethnicity, and BMI on achievement of pathologic complete response following neoadjuvant chemotherapy for breast cancer: a pooled analysis of four prospective Alliance clinical trials (A151426)

Warner

Ballman

Strand

et al. 2016

Breast Cancer Res Treat

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Purpose Previous studies demonstrated poor response to neoadjuvant systemic therapy (NST) for breast cancer among black women and women who are overweight or obese but this may be due to chemotherapy under dosing. We assessed associations of race, ethnicity and body mass index (BMI) with pathologic complete response (pCR) in clinical trial populations. Methods 1797 women enrolled in four NST trials (CALGB 40601, 40603; ACOSOG Z1041, Z1071) were included. Tumor subtypes were defined by estrogen receptor (ER) and HER2 status. Logistic regression generated odds ratios (OR) and 95% confidence intervals (CI) for the associations of race, ethnicity, and BMI with pCR adjusting for subtype, study arm, lymph node status, tumor size, and tumor grade. Results 253 (14.1%) were black, 199 (11.1%) Hispanic, 520 (28.9%) overweight, and 743 (41.4%) obese. Compared to whites, Blacks and Hispanics were more likely to be obese and Blacks were more likely to have triple-negative cancer. pCR rates differed significantly by tumor subtype. In multivariate analyses, neither race (black vs. white: OR: 1.18, 95% CI: 0.85–1.62) nor ethnicity (Hispanic vs. non-Hispanic: OR: 1.30, 95% CI: 0.67–2.53) were significant predictors of pCR overall or by subtype. Overweight and obese women had lower pCR rates in ER+/HER2+, but higher pCR rates in ER−/HER2+ cancers. Conclusions There was no difference in breast pCR according to race or ethnicity. Overall, there was no major difference in pCR rates by BMI. These findings suggest that pCR with optimally dosed NST is a function of tumor, rather than patient, biology.

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Section: Discussionmentioning

confidence: 99%

Impact of race, ethnicity, and BMI on achievement of pathologic complete response following neoadjuvant chemotherapy for breast cancer: a pooled analysis of four prospective Alliance clinical trials (A151426)

Warner

Ballman

Strand

et al. 2016

Breast Cancer Res Treat

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“…187,188 Breast density can also be exploited as an intermediate endpoint in studies on breast cancer etiology. Finally, information on breast density has recently proved useful to predict the pathologic response to neoadjuvant chemo- 189 or endocrine therapy. 190 As mentioned above, x-ray mammography is the gold standard for the assessment of breast density and the method that is generally applied in clinical practice.…”

Section: Assessment Of Breast Density and Estimate Of Cancer Riskmentioning

confidence: 99%

Review of optical breast imaging and spectroscopy

et al. 2016

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Diffuse optical imaging and spectroscopy of the female breast is an area of active research. We review the present status of this field and discuss the broad range of methodologies and applications. Starting with a brief overview on breast physiology, the remodeling of vasculature and extracellular matrix caused by solid tumors is highlighted that is relevant for contrast in optical imaging. Then, the various instrumental techniques and the related methods of data analysis and image generation are described and compared including multimodality instrumentation, fluorescence mammography, broadband spectroscopy, and diffuse correlation spectroscopy. We review the clinical results on functional properties of malignant and benign breast lesions compared to host tissue and discuss the various methods to improve contrast between healthy and diseased tissue, such as enhanced spectroscopic information, dynamic variations of functional properties, pharmacokinetics of extrinsic contrast agents, including the enhanced permeability and retention effect. We discuss research on monitoring neoadjuvant chemotherapy and on breast cancer risk assessment as potential clinical applications of optical breast imaging and spectroscopy. Moreover, we consider new experimental approaches, such as photoacoustic imaging and long-wavelength tissue spectroscopy.

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“…Furthermore, change in MD on the time scale of weeks or months has potential as a predictive marker of response of women to antiestrogens used in both chemoprevention in the high risk setting, or as an adjuvant therapy for oestrogen receptor-positive breast cancers [8,9]. Recent studies have indicated that the potential use of assessing change in MD as a predictive biomarker may also extend to other breast cancer therapies [10]. Therefore, high-frequency observation of MD may find utility in monitoring treatment response.…”

Section: Introductionmentioning

confidence: 99%

Quantification of breast tissue density: Correlation between single-sided portable NMR and micro-CT measurements

Huang

Ali

Nano

et al. 2019

Magnetic Resonance Imaging

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Mammographic density (MD) is a strong independent risk factor for breast cancer. Traditional screening for MD using X-ray mammography involves ionising radiation, which is not suitable for young women, those with previous radiation exposure, or those having undergone a partial mastectomy. Therefore, alternative approaches for MD screening that do not involve ionising radiation will be important as the clinical use of MD increases, and as more frequent MD testing becomes desirable for research purposes. We have previously demonstrated the potential utility of spin relaxation-based, single-sided portable-NMR measurements for the purpose of MD quantification. We present here a more refined analysis by quantifying breast tissue density in excised samples on a continuous scale (0% to 100% fibroglandular tissue content) using micro-CT (CT), and comparing the results to spin-relaxation and diffusion portable-NMR measurements of the same samples. CT analysis of mammary tissues containing high-and low-MD (HMD and LMD, respectively) regions had Hounsfield Unit (HU) histograms with a bimodal pattern, with HMD regions exhibiting significantly higher HU values than LMD regions. Quantitative MD (%HMD) values obtained using CT exhibited an excellent correlation with portable-NMR results, namely longitudinal spin-relaxation time constants (T1) and the relative tissue water content obtained from portable-NMR diffusion measurements (R 2 =0.92, p<0.0001 and R 2 =0.96, p<0.0001, respectively). These findings are consistent with our previous results demonstrating relatively high water content in HMD breast tissue, consistent with the high proportion of fibroglandular tissue, FGT, which in turn contains more abundant water-carrying HSPG proteins. We observed an excellent correlation between the T1 values and diffusion NMR-measured relative tissue water content (R 2 =0.94, p<0.0001). These findings demonstrate, for the first time, the ability of single-sided portable NMR to accurately quantify MD in vitro on a continuous scale. The results also indicate that portable-NMR analysis can assist in the identification of features underpinning MD, namely FGT and adipose tissue content. Future work will involve application of portable NMR to quantifying MD in vivo.

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Mammographic breast density: Predictive value for pathological response to neoadjuvant chemotherapy in breast cancer patients

Abstract: Low mammographic BD, low BMI and early clinical stage were associated with improved pCR rate and lower pathological stage after neoadjuvant chemotherapy. BD had more pronounced association with response to chemotherapy after adjustment with BMI.

Cited by 31 publications

References 33 publications

Impact of race, ethnicity, and BMI on achievement of pathologic complete response following neoadjuvant chemotherapy for breast cancer: a pooled analysis of four prospective Alliance clinical trials (A151426)

Impact of race, ethnicity, and BMI on achievement of pathologic complete response following neoadjuvant chemotherapy for breast cancer: a pooled analysis of four prospective Alliance clinical trials (A151426)

Review of optical breast imaging and spectroscopy

Quantification of breast tissue density: Correlation between single-sided portable NMR and micro-CT measurements

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