Prediction of Pathologic Complete Response by Ultrasonography and Magnetic Resonance Imaging After Neoadjuvant Chemotherapy in Patients with Breast Cancer
Authors Zhang K, Li J, Zhu Q, Chang C
Received 25 January 2020
Accepted for publication 25 March 2020
Published 16 April 2020 Volume 2020:12 Pages 2603—2612
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 3
Editor who approved publication: Dr Sanjeev Srivastava
Kai Zhang,* Jiawei Li,* Qian Zhu, Cai Chang
Department of Medical Ultrasound, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Cai Chang
Fudan University Shanghai Cancer Center, No. 270, Dong’an Road, Shanghai, Xuhui District 200032, People’s Republic of China
Tel +86 180 1731 2605
Fax +86 21 6417 4774
Purpose: To compare the diagnostic performance for pathologic complete response (pCR) in breast cancer after neoadjuvant chemotherapy (NAC) between ultrasound (US) and magnetic resonance imaging (MRI).
Patients and Methods: A total of 1,219 breast cancer patients with 1,232 tumors who accepted US and/or MRI examination after NAC and before breast surgery were included. The diagnostic performance of US, MRI, and US plus MRI in predicting pCR was compared.
Results: The sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) of US for pCR were 36.2%, 90.2%, 71.0%, 67.3%, and 71.9%, respectively, while for MRI they were 44.4%, 92.9%, 75.6%, 77.7%, and 75.0%, respectively. The combination of US and MRI had increased specificity (98.0%) and PPV (86.8%), decreased sensitivity (22.5%) and NPV (68.8%), but similar accuracy (70.5%) in comparison with US or MRI alone. The prediction of pCR by imaging differed in different histological, molecular subtypes and primary tumor size.
Conclusion: Neither US nor MRI could predict a pCR with sufficient accuracy. The combination of US and MRI could not predict a pCR reliably either. The explanation of imaging for pCR should take into account histological, molecular subtypes, and primary tumor size.
Keywords: breast neoplasms, neoadjuvant therapy, pathologic complete response, ultrasonography, magnetic resonance imaging
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.Download Article [PDF] View Full Text [HTML][Machine readable]