Abstract | BACKGROUND: METHODS: We used data from a multicenter trial, collected at 21 study sites (NCT02948764). The trial included women with cT1-3, cN0/+ breast cancer undergoing routine post-neoadjuvant imaging (ultrasound, MRI, mammography) and VAB prior to surgery. We compared the findings of VAB and routine imaging with the histopathologic evaluation of the surgical specimen. RESULTS: Of 398 patients, 34 patients with missing ypN status and 127 patients with luminal tumors were excluded. Among the remaining 237 patients, tumor cells in the VAB indicated a surgical non-pCR in all patients (73/73, positive predictive value [PPV] 100%), whereas PPV of routine imaging after NAST was 56.0% (75/134). Sensitivity of the VAB was 72.3% (73/101), and 74.3% for sensitivity of imaging (75/101). CONCLUSION:
Residual cancer found in a VAB specimen after NAST always corresponds to non-pCR. Residual cancer assumed on routine imaging after NAST corresponds to actual residual cancer in about half of patients. Response assessment by VAB is not safe for the exclusion of residual cancer. Response assessment by biopsies after NAST may allow studying the new concept of extended neoadjuvant treatment for patients with residual disease in future trials.
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Authors | André Pfob, Lie Cai, Andreas Schneeweiss, Geraldine Rauch, Bettina Thomas, Benedikt Schaefgen, Sherko Kuemmel, Toralf Reimer, Markus Hahn, Marc Thill, Jens-Uwe Blohmer, John Hackmann, Wolfram Malter, Inga Bekes, Kay Friedrichs, Sebastian Wojcinski, Sylvie Joos, Stefan Paepke, Tom Degenhardt, Joachim Rom, Achim Rody, Marion van Mackelenbergh, Maggie Banys-Paluchowski, Regina Große, Mattea Reinisch, Maria Margarete Karsten, Chris Sidey-Gibbons, Markus Wallwiener, Michael Golatta, Joerg Heil |
Journal | Annals of surgical oncology
(Ann Surg Oncol)
Vol. 31
Issue 2
Pg. 957-965
(Feb 2024)
ISSN: 1534-4681 [Electronic] United States |
PMID | 37947974
(Publication Type: Multicenter Study, Journal Article)
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Copyright | © 2023. The Author(s). |
Topics |
- Humans
- Female
- Breast Neoplasms
(drug therapy, surgery, pathology)
- Neoadjuvant Therapy
(methods)
- Neoplasm, Residual
(pathology)
- Breast
(pathology)
- Image-Guided Biopsy
(methods)
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