Tumor necrosis by pretreatment breast MRI: association with neoadjuvant systemic therapy (NAST) response in triple-negative breast cancer (TNBC)
Autor: | Jessica W.T. Leung, Rosalind P. Candelaria, Jong Bum Son, Elsa Arribas, Peng Wei, Hagar S. Mahmoud, Jingfei Ma, Marion E. Scoggins, Kenneth R. Hess, Jennifer K. Litton, Abeer H Abdelhafez, Stacy L. Moulder, Vicente Valero, Elizabeth Ravenberg, Alastair M. Thompson, Gary J. Whitman, Huong T. Le-Petross, Beatriz E. Adrada, Tanya W. Moseley, Mark D. Pagel, Gaiane M. Rauch, Deanna L. Lane, Benjamin C. Musall, Ken Pin Hwang, Jason B White, Lumarie Santiago, Wei T. Yang |
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Rok vydání: | 2020 |
Předmět: |
Adult
0301 basic medicine Oncology Cancer Research medicine.medical_specialty Necrosis medicine.medical_treatment Contrast Media Breast Neoplasms Triple Negative Breast Neoplasms Article 03 medical and health sciences 0302 clinical medicine Breast cancer Internal medicine medicine Carcinoma Humans Breast MRI Neoadjuvant therapy Triple-negative breast cancer Retrospective Studies medicine.diagnostic_test business.industry Area under the curve Middle Aged medicine.disease Magnetic Resonance Imaging Neoadjuvant Therapy Diffusion Magnetic Resonance Imaging 030104 developmental biology 030220 oncology & carcinogenesis T-stage Female medicine.symptom business |
Zdroj: | Breast Cancer Res Treat |
ISSN: | 1573-7217 0167-6806 |
Popis: | PURPOSE: To determine if tumor necrosis by pretreatment breast MRI and its quantitative imaging characteristics are associated with response to NAST in TNBC. METHODS: This retrospective study included 85 TNBC patients (mean age 51.8 ± 13 years) with MRI before NAST and definitive surgery during 2010–2018. Each MRI included T2-weighted, diffusion-weighted (DWI), and dynamic contrast-enhanced (DCE) imaging. For each index carcinoma, total tumor volume including necrosis (TTV), excluding necrosis (TV), and the necrosis-only volume (NV) were segmented on early-phase DCE subtractions and DWI images. NV and %NV were calculated. Percent enhancement on early and late phases of DCE and apparent diffusion coefficient were extracted from TTV, TV, and NV. Association between necrosis with pathological complete response (pCR) was assessed using odds ratio (OR). Multivariable analysis was used to evaluate the prognostic value of necrosis with T stage and nodal status at staging. Mann–Whitney U tests and area under the curve (AUC) were used to assess performance of imaging metrics for discriminating pCR vs non-pCR. RESULTS: Of 39 patients (46%) with necrosis, 17 had pCR and 22 did not. Necrosis was not associated with pCR (OR, 0.995; 95% confidence interval [CI] 0.4–2.3) and was not an independent prognostic factor when combined with T stage and nodal status at staging (P = 0.46). None of the imaging metrics differed significantly between pCR and non-pCR in patients with necrosis (AUC < 0.6 and P > 0.40). CONCLUSION: No significant association was found between necrosis by pretreatment MRI or the quantitative imaging characteristics of tumor necrosis and response to NAST in TNBC. |
Databáze: | OpenAIRE |
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