Omission of breast surgery in selected breast cancer patients with excellent response to neoadjuvant systemic therapy

Tasoulis, Marios-Konstantinos; Muktar, Samantha; Smith, Ian; Roche, Nicola; MacNeill, Fiona

doi:10.1016/j.ejso.2024.108277

European Journal of Surgical Oncology

2024

DOI: 10.1016/j.ejso.2024.108277

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Omission of breast surgery in selected breast cancer patients with excellent response to neoadjuvant systemic therapy

Marios-Konstantinos Tasoulis,

Samantha Muktar,

Ian Smith

et al.

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2024

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Performance of Contrast-Enhanced Mammography (CEM) for Monitoring Neoadjuvant Chemotherapy Response among Different Breast Cancer Subtypes

Vidali,

Irmici,

Depretto

et al. 2024

Cancers

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Neoadjuvant chemotherapy (NAT) plays a crucial role in breast cancer (BC) treatment, both in advanced BC and in early-stage BC, with different rates of pathological complete response (pCR) among the different BC molecular subtypes. Imaging monitoring is mandatory to evaluate the NAT efficacy. This study evaluates the diagnostic performance of Contrast-Enhanced Mammography (CEM) in BC patients undergoing NAT. This retrospective two-center study included 174 patients. The breast lesions were classified based on the molecular subtypes in hormone receptor (HR+)/HER2−, HER2+, and triple-negative breast cancer (TNBC). The histopathological analysis performed following surgery was used as a reference standard for the pCR. Sensitivity, specificity, PPV, and NPV were measured overall and for the different subtypes. We enrolled 174 patients, 79/174 (46%) HR+/HER2−, 59/174 (33.9%) HER2+, and 35/174 (20.1%) TNBC; the pCR was found in 64/174 (36.8%), of which 57.1% were TNBCs. In the total population, the CEM sensitivity and specificity were 66.2% and 75.2%, with a PPV of 61.4% and an NPV of 78.8%. The highest specificity (80.9%) and NPV (91.7%) were found in HR+/HER2−, while the highest sensitivity (70%) and PPV appeared (73.7%) in TNBC. The results indicate that CEM is a valid tool to assess the pCR, with different performances among the subtypes of BC.

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Performance of Contrast-Enhanced Mammography (CEM) for Monitoring Neoadjuvant Chemotherapy Response among Different Breast Cancer Subtypes

Vidali,

Irmici,

Depretto

et al. 2024

Cancers

View full text Add to dashboard Cite

show abstract

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Omission of breast surgery in selected breast cancer patients with excellent response to neoadjuvant systemic therapy

Cited by 1 publication

References 18 publications

Performance of Contrast-Enhanced Mammography (CEM) for Monitoring Neoadjuvant Chemotherapy Response among Different Breast Cancer Subtypes

Performance of Contrast-Enhanced Mammography (CEM) for Monitoring Neoadjuvant Chemotherapy Response among Different Breast Cancer Subtypes

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