Correlation between MRI morphological response patterns and histopathological tumor regression after neoadjuvant endocrine therapy in locally advanced breast cancer: a randomized phase II trial
| Autor: | Hossein Schandiz, Maryam Lahooti, Owen Thomas, Marianne Lyngra, Joana Reis, Joao Boavida, Kjell-Inge Gjesdal, Jürgen Geisler, Jonn Terje Geitung, Torill Sauer |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Cancer Research
medicine.medical_specialty Breast Neoplasms Exemestane chemistry.chemical_compound Breast cancer medicine Endocrine system Humans Locally advanced breast cancer Tumor cellularity Tumor Regression Grade business.industry Letrozole Histology medicine.disease Clinical Trial Magnetic Resonance Imaging Neoadjuvant Therapy Regimen Response patterns Treatment Outcome Oncology chemistry Histopathology Female Radiology business medicine.drug MRI |
| Zdroj: | Breast Cancer Research and Treatment |
| ISSN: | 1573-7217 0167-6806 |
| Popis: | Purpose To correlate MRI morphological response patterns with histopathological tumor regression grading system based on tumor cellularity in locally advanced breast cancer (LABC)-treated neoadjuvant with third-generation aromatase inhibitors. Methods Fifty postmenopausal patients with ER-positive/HER-2-negative LABC treated with neoadjuvant letrozole and exemestane given sequentially in an intra-patient cross-over regimen for at least 4 months with MRI response monitoring at baseline as well as after at least 2 and 4 months on treatment. The MRI morphological response pattern was classified into 6 categories: 0/complete imaging response; I/concentric shrinkage; II/fragmentation; III/diffuse; IV/stable; and V/progressive. Histopathological tumor regression was assessed based on the recommendations from The Royal College of Pathologists regarding tumor cellularity. Results Following 2 and 4 months with therapy, the most common MRI pattern was pattern II (24/50 and 21/50, respectively). After 4 months on therapy, the most common histopathological tumor regression grade was grade 3 (21/50). After 4 months an increasing correlation is observed between MRI patterns and histopathology. The overall correlation, between the largest tumor diameter obtained from MRI and histopathology, was moderate and positive (r = 0.50, P-value = 2e-04). Among them, the correlation was highest in type IV (r = 0.53). Conclusion The type II MRI pattern “fragmentation” was more frequent in the histopathological responder group; and types I and IV in the non-responder group. Type II pattern showed the best endocrine responsiveness and a relatively moderate correlation between sizes obtained from MRI and histology, whereas type IV pattern indicated endocrine resistance but the strongest correlation between MRI and histology. |
| Databáze: | OpenAIRE |
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