utd_medknow
Indian Journal of Cancer
Home  ICS  Feedback Subscribe Top cited articles Login 
Users Online :590
Small font sizeDefault font sizeIncrease font size
Resource Links
     Search Pubmed for
 
    -  Sudhir R
    -  Koppula VC
    -  Rao T S
    -  Sannapareddy K
    -  Rajappa SJ
    -  Murthy SS
 

 Article Access Statistics
    Viewed1225    
    PDF Downloaded13    

Recommend this journal

 

 ORIGINAL ARTICLE

Accuracy of digital mammography, ultrasound and MRI in predicting the pathological complete response and residual tumor size of breast cancer after completion of neoadjuvant chemotherapy


1 Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
2 Department of Surgical oncology, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
3 Department of Medical oncology, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India
4 Department of Pathology and Lab medicine, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad, India

Correspondence Address:
Rashmi Sudhir,
Department of Radiodiagnosis, Basavatarakam Indo-American Cancer Hospital and Research Centre, Hyderabad
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ijc.IJC_795_19

PMID: 33753611

Background: Neoadjuvant chemotherapy (NACT) is the standard of care for the treatment of locally advanced or non-metastatic breast cancer, which may increase the chances of breast conservative surgery (BCS) in place of radical mastectomy without compromising on the overall survival. The aim of this study was to evaluate the accuracy of mammography (MG), ultrasound (US), and magnetic resonance imaging (MRI) in predicting the complete response and to assess the extent of residual breast cancer in women treated with NACT. Materials and Methods: Fifty-six consecutive patients with stage II or III breast cancer, who underwent imaging evaluation of breast with digital mammogram, US, and MRI after NACT and before the breast surgery, were included in the study. For each patient, pathologic complete response (pCR) or residual tumor (non-pCR) was predicted and the maximum extent of the residual tumor was measured on each imaging modality. These measurements were subsequently compared with the final histopathology results. Results: Of 56 patients, 22 showed pCR with MRI having better accuracy for predicting complete response than the MG and US (area under the receiver operating characteristic curve: 0.86, 0.68, and 0.65, respectively; p = 0.0001 for MRI; p = 0.06 for MG, and p = 0.02 for US). The sensitivity of MRI for detecting pCR was 72.7%; specificity and positive predictive value were 100%. For pathological residual tumor, the size measured on MRI showed significantly higher correlation with the pathologic size (correlation coefficient, r = 0.786), than the MG (r = 0.293) and US (r = 0.508) with P < 0.05. Conclusions: Accuracy of MRI for predicting pathological complete response was significantly higher than the MG and US. Pathologic residual tumor size was also more precisely reflected by the longest tumor dimension on MRI with the strong positive correlation coefficient.




  Site Map | What's new | Copyright and Disclaimer
  Online since 1st April '07
  2007 - Indian Journal of Cancer | Published by Wolters Kluwer - Medknow