Effect of neoadjuvant chemotherapy on breast tissue composition: a longitudinal mammographic study with automated volumetric measurement

• Published in: European radiology 2020-09, Vol.30 (9), p.4785-4794
• Main Authors: Jang, Hyeon Jun, Kim, Hye Jung, Chae, Yee Soo, Lee, Soo Jung, Kim, See Hyung, Lee, Hoseok, Kim, Won Hwa
• Format: Article
• Language: English
• Subjects: Adult; Age; Aged; Automation; Breast; Breast - diagnostic imaging; Breast - drug effects; Breast cancer; Breast Density - drug effects; Breast Neoplasms - drug therapy; Chemotherapy; Chemotherapy, Adjuvant; Composition; Density; Diagnostic Radiology; Female; Humans; Imaging; Internal Medicine; Interventional Radiology; Longitudinal Studies; Mammography; Measurement methods; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy; Neuroradiology; Organ Size - drug effects; Radiology; Reduction; Regression Analysis; Retrospective Studies; Software; Tissues; Ultrasound; Variance analysis
• ISSN: 0938-7994; 1432-1084
• DOI: 10.1007/s00330-020-06830-9

Objectives To investigate the effect of neoadjuvant chemotherapy (NAC) on breast tissue composition with mammographic automated volumetric measurement. Methods This retrospective study included 168 breast cancer patients who were treated with NAC and underwent serial mammography (pre-treatment, mid-treatment, and post-treatment) between January 2015 and October 2018. Automated volumetric measurements of the contralateral breast volume (BV), fibroglandular volume (FGV), and breast density (BD) were performed using Volpara software. BD grades were divided into 4 groups by Volpara density grade (VDG). The longitudinal changes in BV, FGV, BD, and their associated factors were evaluated. Results Repeated-measures analysis of variance demonstrated a significant reduction in BV, FGV, and BD over time ( p <  0.001, p <  0.001, and p  = 0.002, respectively). BV showed a greater reduction in the second half than in the first half (− 28.6 cm 3 vs. − 15.2 cm 3 ), BD showed a greater reduction in the first half than in the second half (− 0.8% vs. − 0.1%), and FGV steadily decreased (− 4.6 cm 3 and − 3.9 cm 3 in the first and second halves). On multivariable linear regression analysis, chemotherapy regimen was associated with BV change between pre- and post-treatment ( p  = 0.002); age ( p  = 0.024) and VDG ( p  = 0.027) were associated with FGV change; age ( p  = 0.037), VDG ( p  = 0.002), and chemotherapy regimen ( p  = 0.003) were associated with BD change. Conclusions NAC affects breast tissue composition, reflected as reductions in BV, FGV, and BD. Mammography with automated volumetric measurement can capture quantitative changes in these breast tissue parameters during NAC. Key Points • Neoadjuvant chemotherapy (NAC) affects breast tissue composition with different patterns of reduction in breast volume, fibroglandular volume, and breast density. • Age, Volpara density grades, and NAC regimen were independent factors associated with breast density change between pre-treatment and post-treatment. • Mammography with automated volumetric measurement enables identification of longitudinal changes in breast tissue composition.