Mammographic and Ultrasonographic Imaging Analysis for Neoadjuvant Chemotherapy Evaluation: Volume Reduction Indexes That Correlate With Pathological Complete Response

Introduction: We aimed to evaluate volume reduction in digital mammography (DM) and ultrasound (US) for neoadjuvant chemotherapy (NAC) evaluation, with breast cancer-specific survival and pathological complete response (pCR) associations.Methods: This is a retrospective observational cohort study an...

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Published in:Curēus (Palo Alto, CA) CA), 2022-10, Vol.14 (10), p.e29960-e29960
Main Authors: Mello, Juliana M, Sarvacinski, Flavia, Schaefer, Flavia C, Ercolani, Daniel S, Lobato, Nathalia R, Martins, Yasmine C, Zwetsch, Guilherme, Bittelbrunn, Fernando P, Ferreira, Charles F, Damin, Andrea P
Format: Article
Language:English
Subjects:
Breast cancer
Chemotherapy
Magnetic resonance imaging
Mammography
Medical prognosis
Morphology
Obstetrics/Gynecology
Oncology
Radiology
Statistical significance
Surgery
Ultrasonic imaging
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Summary:Introduction: We aimed to evaluate volume reduction in digital mammography (DM) and ultrasound (US) for neoadjuvant chemotherapy (NAC) evaluation, with breast cancer-specific survival and pathological complete response (pCR) associations.Methods: This is a retrospective observational cohort study analyzing recorded images in 122 selected subjects out of which 569 patients presented with advanced breast cancers. Spearman’s correlation and generalized estimating equations (GEE) compared volume reduction on DM and US between pCR and non-pCR after NAC with post-surgical anatomopathology. Cox regression and Kaplan-Meier curves analyzed associations between cancer-specific survival, pCR, and volume reductions.Results: A total of 34.4% (N=42) obtained pCR and 65.6% (N=80) did not. Minimum percentage indexes needed to correlate with pCR over time were, at least, 28.9% for DM (p=0.006) and 10.36% for US (p=0.046), with high specificity (US=98%, DM=93%) but low sensitivity (US=7%, DM=18%). Positive predictive values were 82% (DM) and 86% (US) and negative predictive values were 37% (DM) and 36% (US). Cox regression and Kaplan-Meier curves demonstrated associations of breast cancer-specific survival with pCR (Cox regression coefficient {B}=0.209, CI 95%=0.048-0.914, p=0.038).Conclusions: At least 28.9% of volume reduction on DM and 10.36% of volume reduction on US are correlated with pCR. Furthermore, pCR was associated with breast cancer-specific survival after NAC in volumetric morphological imaging analysis.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.29960