Abstract
Background: Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes. Methods: Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values. Results: A total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by < 10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, NPV (proportion of correctly predicted tumor size ≤10 mm) of MRI and ultrasound was 0.92 and 0.83; PPV (correctly predicted tumor size > 10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR−/HER2+ tumors. Both methods had a comparable NPV and PPV in HR−/HER2− tumors. Conclusions: In HR+/HER2+ and HR−/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT. Trial registration: Clinicaltrials.gov, NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).
| Original language | English |
|---|---|
| Article number | 36 |
| Journal | Breast Cancer Research |
| Volume | 23 |
| Issue number | 1 |
| Pages (from-to) | 36 |
| ISSN | 1465-5411 |
| DOIs | |
| Publication status | Published - 18.03.2021 |
Funding
Medical writing and editorial support were provided by Lukasz Wujak, Lukasz Wujak MedComms, Warsaw, Poland, and were funded by WSG GmbH, Moenchengladbach, Germany. The analysis of MRI data presented in this manuscript was funded by Bayer AG Germany. ADAPT HER2+/HR+ and WSG-ADAPT HER2+/HR− trials were financially supported by Hoffmann la Roche; the WSG-ADAPT TN trial was financially supported by Celgene and Teva. The industry sponsors of the ADAPT trials had no role in the trial design, data collection, analysis, data interpretation, writing, or decision to submit the manuscript. Open Access funding enabled and organized by Projekt DEAL. LU received honoraria, travel support and served in consulting/advisory role for Siemens Healthcare, Bayer Healthcare, and received research funding from Siemens Healthcare. CKL has an ownership interest in Theraklion and Phaon Scientific; received honoraria from Roche, AstraZeneca, Celgene, Novartis, Pfizer, Lilly, Hexal, Amgen, SonoScape, Pfizer, Novartis, Roche, Genomic Health, Amgen, AstraZeneca, Riemser, Carl Zeiss MediTec, TEVA Pharmaceuticals Industries, Theraklion, Janssen-Cilag, GlaxoSmithKline, and LIV Pharma; served in consulting/advisory role for Roche, Novartis, Pfizer, Celgene, Phaon Scientific, Pfizer, Novartis, SurgVision, CarlZeissMeditec, Amgen, and Onkowissen; received research funding from Roche, Novartis, and Pfizer; and received travel support from Roche, Daiichi Sankyo, Novartis, Carl Zeiss Meditec, LIV Pharma, Novartis, Amgen, Pfizer, and Daiichi Sankyo. UN has an ownership interest in WSG GmbH; received honoraria from Agendia, Amgen, Celgene, Genomic Health, NanoString Technologies, Novartis pharma SAS, Pfizer Pharmaceuticals Israel, Roche/Genentech, and Teva; served in consulting/advisory role for Genomic Health and Roche; received research funding from Agendia, Amgen, Celgene, Genomic Health, NanoString Technologies, Roche, and Sanofi; provided expert testimony for Genomic Health; and received travel support from Genomic Health, Pfizer Pharmaceuticals Israel, and Roche.
Research Areas and Centers
- Academic Focus: Biomedical Engineering
