2017
DOI: 10.1158/1538-7445.sabcs16-p5-16-30
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Abstract P5-16-30: Feasibility trial for identification of patients for eliminating breast cancer surgery following neoadjuvant systemic therapy

Abstract: Background: Contemporary improved neoadjuvant systemic therapy (NST) for breast cancer may result in a pathologic complete response (pCR) in up to 60% of patients (pts) yet imaging alone has a poor negative predictive value to determine which pts might be spared surgery. This study was designed to evaluate the hypothesis that percutaneous image guided biopsy after NST can accurately identify patients who may forgo surgery. Methods: Prospective single-center IRB approved study of 34 pts with clin… Show more

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Cited by 3 publications
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“…Prior clinical studies that aimed to eliminate surgery in exceptional responders did not meet the threshold of success for the routine omission of surgery among these patients owing to the inability to reliably identify patients with a breast pCR. Outstanding initial results from the MD Anderson feasibility trial using extensive image-guided sampling of the tumor bed after NCT have provided an opportunity to test the hypothesis that surgery may be eliminated in many patients with a documented breast pCR.…”
Section: Discussionmentioning
confidence: 99%
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“…Prior clinical studies that aimed to eliminate surgery in exceptional responders did not meet the threshold of success for the routine omission of surgery among these patients owing to the inability to reliably identify patients with a breast pCR. Outstanding initial results from the MD Anderson feasibility trial using extensive image-guided sampling of the tumor bed after NCT have provided an opportunity to test the hypothesis that surgery may be eliminated in many patients with a documented breast pCR.…”
Section: Discussionmentioning
confidence: 99%
“…Initial attempts at elimination of surgery among patients with a complete clinical response were unsuccessful, because imaging of the breast and lymph nodes had a poor negative predictive value for a pCR and therefore was associated with unacceptable local regional recurrence rates after radiotherapy alone . However, use of improved imaging techniques with extensive vacuum-assisted core biopsy and fine-needle aspiration (FNA) biopsy of the known tumor bed (with removal of the initially placed clip) has recently been shown to accurately identify patients with a pCR and in whom significant residual disease in the breast is unlikely . In the initial results of the MD Anderson feasibility clinical trial with 34 patients, the use of image-guided biopsy was associated with 100% accuracy and no false-negative findings for the determination of residual disease in the breast after NCT.…”
Section: Introductionmentioning
confidence: 99%
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“…The accuracy of fine-needle aspiration (FNA) and vacuum-assisted core biopsy (VACB) was determined in assessing pCR (no invasive or in situ disease) following NST. 16 The sample size of 40 was determined to provide sufficient information to characterize the diagnostic properties of VACB assuming an estimated 90% sensitivity and specificity for VACB after NST. Forty patients with clinical T1-3N0-3 limited to TN or HER2-positive breast cancer receiving NST were enrolled.…”
Section: Feasibility Trial For Identification Of Patients For Elimina...mentioning
confidence: 99%