Breast MRI radiomics for the pre-treatment prediction of response to neoadjuvant chemotherapy in node-positive breast cancer patients

2019 ◽  
Author(s):  
Karen Drukker ◽  
Iman El-Bawab ◽  
Alexandra Edwards ◽  
Christopher Doyle ◽  
John Papaioannou ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Breast Mri ◽  
Breast Cancer Patients ◽  
Prediction Of Response ◽  
Treatment Prediction ◽  
Pre Treatment ◽  
Response To Neoadjuvant Chemotherapy ◽  
Positive Breast Cancer

scholarly journals Radiomics of MRI for the Prediction of the Pathological Response to Neoadjuvant Chemotherapy in Breast Cancer Patients: A Single Referral Centre Analysis

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4271
Author(s):  
Filippo Pesapane ◽  
Anna Rotili ◽  
Francesca Botta ◽  
Sara Raimondi ◽  
Linda Bianchini ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Multivariable Analysis ◽  
Breast Mri ◽  
Breast Cancer Patients ◽  
Surgical Specimen ◽  
Receiver Operating Characteristic Curves ◽  
Contrast Enhanced ◽  
Treatment Prediction ◽  
Pre Treatment

Objectives: We aimed to determine whether radiomic features extracted from a highly homogeneous database of breast MRI could non-invasively predict pathological complete responses (pCR) to neoadjuvant chemotherapy (NACT) in patients with breast cancer. Methods: One hundred patients with breast cancer receiving NACT in a single center (01/2017–06/2019) and undergoing breast MRI were retrospectively evaluated. For each patient, radiomic features were extracted within the biopsy-proven tumor on T1-weighted (T1-w) contrast-enhanced MRI performed before NACT. The pCR to NACT was determined based on the final surgical specimen. The association of clinical/biological and radiomic features with response to NACT was evaluated by univariate and multivariable analysis by using random forest and logistic regression. The performances of all models were assessed using the areas under the receiver operating characteristic curves (AUC) with 95% confidence intervals (CI). Results: Eighty-three patients (mean (SD) age, 47.26 (8.6) years) were included. Patients with HER2+, basal-like molecular subtypes and Ki67 ≥ 20% presented a pCR to NACT more frequently; the clinical/biological model’s AUC (95% CI) was 0.81 (0.71–0.90). Using 136 representative radiomics features selected through cluster analysis from the 1037 extracted features, a radiomic score was calculated to predict the response to NACT, with AUC (95% CI): 0.64 (0.51–0.75). After combining the clinical/biological and radiomics models, the AUC (95% CI) was 0.83 (0.73–0.92). Conclusions: MRI-based radiomic features slightly improved the pre-treatment prediction of pCR to NACT, in addiction to biological characteristics. If confirmed on larger cohorts, it could be helpful to identify such patients, to avoid unnecessary treatment.

Axillary ultrasonography combined with pre-operative wire localisation of clipped node in nodal restaging after neoadjuvant chemotherapy in node positive breast cancer patients: a pilot study

2021 ◽  
pp. 20210788
Author(s):  
Vishnu Prasad Pulappadi ◽  
Shashi Paul ◽  
Smriti Hari ◽  
Ekta Dhamija ◽  
Smita Manchanda ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Axillary Lymph ◽  
Breast Cancer Patients ◽  
Ultrasound Guided ◽  
Node Positive ◽  
Pre Treatment ◽  
Positive Breast Cancer

Objective: To evaluate the role of axillary ultrasonography (axUS) and ultrasound-guided pre-operative wire localisation of pre-treatment positive clipped node (CN) for prediction of nodal response to neoadjuvant chemotherapy (NACT) in node positive breast carcinoma patients. Methods and materials: A prospective study was conducted between June 2018 and August 2020 after Ethics Committee approval. Breast carcinoma patients (cT1-cT4b) with palpable axillary nodes (cN1-cN3) and suitable for NACT were recruited after written informed consent. Single, most suspicious node was biopsied and clipped. Nodal response to NACT was assessed on axUS. Wire localisation of CN was performed prior to axillary lymph node dissection (ALND). Diagnostic performances of axUS and CN excision were assessed. Results: Of the 69 patients evaluated, 32 patients (mean age, 43.5 ± 11.8 years; females, 31/32 [97%]; pre-menopausal, 18/32 [56.3%]) with metastatic nodes who received NACT were included. Nodal pathological complete response rate was 34.4% (11/32) overall and 70% (7/10) in patients with ≤2 suspicious nodes on pre-NACT axUS. False-negative rates (FNRs) of axUS and CN excision were 4.8% and 28.6% respectively. Combination of post-NACT axUS and CN excision had an FNR of 4.8% overall and 0% in patients with ≤2 suspicious nodes on pre-NACT axUS. Conclusion: Combination of AxUS and ultrasound-guided wire localisation of pre-treatment positive CN has high diagnostic accuracy for nodal restaging after NACT in node positive breast cancer patients. Advances in knowledge: Addition of axUS assessment to wire localisation of CN reduces its FNR for detecting residual metastasis after NACT.

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