Dataset Information

Multivariable Models Based on Baseline Imaging Features and Clinicopathological Characteristics to Predict Breast Pathologic Response after Neoadjuvant Chemotherapy in Patients with Breast Cancer.

ABSTRACT:

Introduction

Currently, the accurate evaluation and prediction of response to neoadjuvant chemotherapy (NAC) remains a great challenge. We developed several multivariate models based on baseline imaging features and clinicopathological characteristics to predict the breast pathologic complete response (pCR).

Methods

We retrospectively collected clinicopathological and imaging data of patients who received NAC and subsequent surgery for breast cancer at our hospital from June 2014 till September 2020. We used mammography, ultrasound, and magnetic resonance imaging (MRI) to investigate the breast tumors at baseline.

Results

A total of 308 patients were included and 111 patients achieved pCR. The HER-2 status and Ki-67 index were significant factors for pCR on univariate analysis and in all multivariate models. Among the prediction models in this study, the ultrasound plus MRI model performed best, producing an area under curve of 0.801 (95% CI 0.749-0.852), a sensitivity of 0.797, and a specificity of 0.676.

Conclusion

Among the multivariable models constructed in this study, the ultrasound plus MRI model performed best in predicting the probability of pCR after NAC. Further validation is required before it is generalized.

SUBMITTER: Chen P

PROVIDER: S-EPMC9247529 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

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Publications

Multivariable Models Based on Baseline Imaging Features and Clinicopathological Characteristics to Predict Breast Pathologic Response after Neoadjuvant Chemotherapy in Patients with Breast Cancer.

Chen Peixian P Wang Chuan C Lu Ruiliang R Pan Ruilin R Zhu Lewei L Zhou Dan D Ye Guolin G

Breast care (Basel, Switzerland) 20211223 3

<h4>Introduction</h4>Currently, the accurate evaluation and prediction of response to neoadjuvant chemotherapy (NAC) remains a great challenge. We developed several multivariate models based on baseline imaging features and clinicopathological characteristics to predict the breast pathologic complete response (pCR).<h4>Methods</h4>We retrospectively collected clinicopathological and imaging data of patients who received NAC and subsequent surgery for breast cancer at our hospital from June 2014 ...[more]

PMID: 35957948

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Project description:BackgroundTo investigate the association of axillary pathologic complete response (pCR) rate among breast cancer patients with pCR after neoadjuvant chemotherapy (NCT).MethodsThe retrospective clinical data of 1,903 patients who were treated with NCT between March, 2010 and December, 2018, were collected from one Chinese database and analyzed. The correlations between clinicopathological characteristics and breast pCR with axillary pCR were calculated by χ2 test. Binary logistic regression analysis was used for multivariate analysis. The relative risk of positive axillary nodes after NCT in patients with and without breast pCR was analyzed using a Cochran-Mantel-Haenszel (CMH) test stratified by initial N stage and tumor subtype.ResultsThe rate of axillary pCR was increased in the cases with initial cN0, Ki67 high expression, HR+HER2+/HR-HER2+/TN subtypes, and breast pCR. After NCT, the relative risk of nodal disease burden was 4.81 in patients without breast pCR compared with patients with breast pCR. The relative risk of positive nodal status in patients with cN0, cN1, cN2, and cN3 disease without vs. with breast pCR was 6.45, 4.88, 5.69 and 6.24, respectively. The relative risk of positive nodal status in patients with HR+HER2-, HR+HER2+, HR-HER2+, and TN disease was 4.02, 4.50, 3.82 and 4.18, respectively. Of cN0 patients with breast pCR, only 4 out of 44 (9%) with HER2-positive disease had 1 or 2 axillary lymph node metastases at final surgical pathology compared to 30 out of 98 (31%) of those without breast pCR. There was no evidence of positive nodal residue among all 21 patients (100%) with TN disease compared to 65% (36 of 55) of patients without breast pCR.ConclusionsNodal status is strongly correlated with breast pCR after NCT. Patients with initial cN0/1 TN/HER2 positive disease who achieve breast pCR at surgery have a low risk of nodal metastasis. These results suggest that the failure rate of missing positive lymph nodes among those patients was very low and that it is safe for such patients to undergo sentinel lymph node biopsy (SLNB) after NCT. This study also provides a theoretical basis for clinical trials focused on the avoidance of axillary surgery in selected patients.

Dataset Information

Multivariable Models Based on Baseline Imaging Features and Clinicopathological Characteristics to Predict Breast Pathologic Response after Neoadjuvant Chemotherapy in Patients with Breast Cancer.

Introduction

Methods

Results

Conclusion

Publications

Multivariable Models Based on Baseline Imaging Features and Clinicopathological Characteristics to Predict Breast Pathologic Response after Neoadjuvant Chemotherapy in Patients with Breast Cancer.

Similar Datasets

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