Imaging performance in guiding response to neoadjuvant therapy according to breast cancer subtypes: A systematic literature review

Lindenberg, Melanie; Miquel-Cases, Anna; Retèl, Valesca P.; Sonke, Gabe S.; Wesseling, Jelle; Stokkel, Marcel P. M.; Harten, Wim H. van

doi:10.1016/j.critrevonc.2017.02.014

Cited by 24 publications

(17 citation statements)

References 45 publications

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“…The performance of either PET/CT or MRI alone was shown much different among breast cancer subtypes. Therefore, imaging techniques based on subtypes for personalizing may further improve their performance in NAC monitoring 29 . However, after reviewing the 12 included articles, only two studies with knowledge of the breast cancer subtypes were identified in our study (Table S2 ).…”

Section: Discussionmentioning

confidence: 99%

Direct comparison of PET/CT and MRI to predict the pathological response to neoadjuvant chemotherapy in breast cancer: a meta-analysis

Chen

Yang

Bao³

et al. 2017

Sci Rep

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Both PET/CT and breast MRI are used to assess pathological complete response to neoadjuvant chemotherapy (NAC) in patients with breast cancer. The aim is to compare the utility of PET/CT and breast MRI by using head-to-head comparative studies. Literature databases were searched prior to July 2016. Eleven studies with a total of 527 patients were included. For PET/CT, the pooled SEN was 0.87 (95% confidence interval (CI): 0.71–0.95) and SPE was 0.85 (95% CI: 0.70–0.93). For MRI, the pooled SEN was 0.79 (95% CI: 0.68–0.87) and SPE was 0.82 (95% CI: 0.72–0.89). In the conventional contrast enhanced (CE)-MRI subgroup, PET/CT outperformed conventional CE-MRI with a higher pooled sensitivity (0.88 (95% CI: 0.71, 0.95) vs. 0.74 (95% CI: 0.60, 0.85), P = 0.018). In the early evaluation subgroup, PET/CT was superior to MRI with a notable higher pooled specificity (0.94 (95% CI: 0.78, 0.98) vs. 0.83 (95% CI: 0.81, 0.87), P = 0.015). The diagnostic performance of MRI is similar to that of PET/CT for the assessment of breast cancer response to NAC. However, PET/CT is more sensitive than conventional CE-MRI and more specific if the second imaging scan is performed before 3 cycles of NAC.

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Section: Discussionmentioning

confidence: 99%

Direct comparison of PET/CT and MRI to predict the pathological response to neoadjuvant chemotherapy in breast cancer: a meta-analysis

Chen

Yang

Bao³

et al. 2017

Sci Rep

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“…It is not clear if tumor resolution on CT, MR or metabolic imaging corresponds to absence of tumor cells. Neither of these three modalities were shown to accurately predict pathologic complete response when studied in patients with breast cancer who were imaged following neoadjuvant chemotherapy and proceeded to surgery (FDG PET/CT shows sensitivity of 38%–89% and specificity of 74%–100%, MRI shows sensitivity of 35%–37% and specificity of 87%–89%) . In order to select patients with breast cancer for de‐escalation of treatment by omitting surgery after neoadjuvant chemotherapy, the only satisfactory technique to determine absence of viable tumor cells was adequate sampling of the tumor bed using stereotactic image guided biopsies .…”

Section: Opening Statementsmentioning

confidence: 99%

Three discipline collaborative radiation therapy special debate: All head and neck cancer patients with intact tumors/nodes should have scheduled adaptive replanning performed at least once during the course of radiotherapy

Soisson

Guerrieri

Balasubramanian

et al. 2019

J Applied Clin Med Phys

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“…Response can be assessed either clinically or radiologically and improved techniques for detection of early response may permit treatment strategies to be adjusted in non-responders (e.g. change of neoadjuvant regimen or proceed to surgery) 36 . Accurate prediction of response may increase the reliability of surgical decision-making when evaluating potential down-staging for breast conservation.…”

Section: Monitoring Response To Neoadjuvant Therapymentioning

confidence: 99%

Opportunities and priorities for breast surgical research

Cutress

McIntosh

Potter

et al. 2018

The Lancet Oncology

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Background: The Breast Cancer Campaign Gap analysis (2013) established breast cancer research priorities without specific focus on surgical research nor the role of surgeons. The majority of breast cancer patients encounter a surgeon at diagnosis or during treatment, thus surgical involvement in design and delivery of high-quality research to improve patient care is critical. This review aims to identify opportunities and priorities for breast surgical research to complement the previous gap analysis. Methods: Research-active breast surgeons met and identified topic areas for breast surgical research which mapped to the patient pathway. These included diagnosis, neoadjuvant treatment, surgery, adjuvant therapy and special groups (e.g. risk-reducing surgery). Section leads were identified based on research interests with invited input from experts in specific areas, supported by consultation with the Association of Breast Surgery (ABS) membership and Independent Cancer Patients' Voice (ICPV). The document was iteratively modified until participants were satisfied that key priorities for surgical research were clear. Results: Key research gaps were identified for each topic area including: (1) issues surrounding overdiagnosis and treatment; (2) optimising selection for neoadjuvant therapies and subsequent surgery; (3) reducing re-operation rates for breast conserving surgery; (4) generating evidence for the clinical and cost-effectiveness of breast reconstruction and mechanisms for evaluating novel interventions; (5) determining optimal axillary management, especially post-neoadjuvant treatment; (6) defining and standardising indications for risk-reducing surgery. Strategies for resolving these knowledge gaps are proposed. Conclusions: Surgeons are ideally placed for a central role in breast cancer research and should foster a culture of engagement and participation in research to benefit patients and the NHS. Development of infrastructure and surgical research capacity together with appropriate allocation of research funding will be needed to successfully address the key clinical and translational research gaps highlighted in this analysis within the next two decades.

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Imaging performance in guiding response to neoadjuvant therapy according to breast cancer subtypes: A systematic literature review

Cited by 24 publications

References 45 publications

Direct comparison of PET/CT and MRI to predict the pathological response to neoadjuvant chemotherapy in breast cancer: a meta-analysis

Direct comparison of PET/CT and MRI to predict the pathological response to neoadjuvant chemotherapy in breast cancer: a meta-analysis

Three discipline collaborative radiation therapy special debate: All head and neck cancer patients with intact tumors/nodes should have scheduled adaptive replanning performed at least once during the course of radiotherapy

Opportunities and priorities for breast surgical research

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