Locally advanced breast carcinoma: computer assisted semiquantitative analysis of color Doppler ultrasonography in the evaluation of tumor response to neoadjuvant chemotherapy (work in progress).

2000 ◽  
Vol 19 (9) ◽  
pp. 601-607 ◽  
Author(s):  
S Huber ◽  
M Medl ◽  
T Helbich ◽  
S Taucher ◽  
T Wagner ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Doppler Ultrasonography ◽  
Tumor Response ◽  
Color Doppler ◽  
Locally Advanced ◽  
Color Doppler Ultrasonography ◽  
Computer Assisted ◽  
Semiquantitative Analysis ◽  
Response To Neoadjuvant Chemotherapy

scholarly journals Assessment of pathological response to neoadjuvant chemotherapy in patients with breast carcinoma using Sataloff system

2019 ◽  
Vol 25 (2) ◽  
pp. 13-18
Author(s):  
Savita Agarwal ◽  
Pinki Pandey ◽  
Megha Ralli ◽  
Vineet Chaturvedi ◽  
Kailash Mittal ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Partial Response ◽  
Tumor Response ◽  
Ductal Carcinoma ◽  
Residual Disease ◽  
Locally Advanced ◽  
Pathological Response ◽  
Pathological Examination ◽  
Response To Neoadjuvant Chemotherapy

Background: Neoadjuvant chemotherapy is frequently administered to patients with breast carcinoma. Response to chemotherapeutic regime can be assessed clinically as well as by pathological examination of the breast tissue. It is essential to accurately categorize the patients with residual disease according to the standard guidelines for pathological evaluation of breast specimens after neoadjuvant chemotherapy. The present study was undertaken to assess the histomorphological changes in mastectomy specimens and axillary lymphatic nodes of patients receiving neoadjuvant chemotherapy, grade the pathological response using Sataloff system and to compare the clinical and pathological response after neoadjuvant chemotherapy. Methods: Present prospective study included a total of 31 patients with locally advanced breast carcinoma, diagnosed with infiltrating ductal carcinoma, not otherwise specified on biopsy specimen and subsequently treated with 2 to 6 cycles of neoadjuvant chemotherapy. Pathological response to neoadjuvant chemotherapy was assessed in breast and axillary lymphatic nodes according to Sataloff criteria. Results: Clinical response observed was complete (cCR) in four cases (12.9%), partial response (cPR) in 24 cases (77.4%), and no response (cNR) in three cases (9.7%). Based on tumor response, breast and lymph nodes were graded as pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR) in five (16.1%), 18 (58.1%) and eight (25.8%) cases respectively using Sataloff criteria. Ductal carcinoma in situ and lymphovascular invasion were seen in 11 (35.4%) and 16 cases (51.6%), respectively. Conclusion: The pathological assessment of tumor response remains the gold standard, as neither the clinical nor the radiological responses are sensitive predictors of tumor response after treatment. However pathological examination is quite challenging and demands sufficient experience along with detailed clinical and radiological data of pre- and postoperative neoadjuvant chemotherapy for precise response evaluation.

scholarly journals Assessment of Pathological Response of Breast Carcinoma in Modified Radical Mastectomy Specimens after Neoadjuvant Chemotherapy

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Dhanya Vasudevan ◽  
P. S. Jayalakshmy ◽  
Suresh Kumar ◽  
Siji Mathew
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Tumor Response ◽  
Ductal Carcinoma ◽  
Locally Advanced ◽  
Radical Mastectomy ◽  
Tumor Characteristics ◽  
Modified Radical Mastectomy ◽  
Tumor Bed

Aim. Paclitaxel based neoadjuvant chemotherapy regimen (NAT) in the setting of locally advanced breast cancer (LABC) can render inoperable tumor (T4, N2/N3) resectable. The aim of this study was to assess the status of carcinoma in the breast and lymph nodes after paclitaxel based NAT in order to find out the patient and the tumor characteristics that correspond to the pathological responses which could be used as a surrogate biomarker to assess the treatment response.Materials and Methods. Clinical and tumor characteristics of patients with breast carcinoma (n=48) were assessed preoperatively. These patients were subjected to modified radical mastectomy after 3 courses of paclitaxel based NAT regimen. The pathological responses of the tumor in the breast and the lymph nodes were studied by using Chevallier’s system which graded the responses into pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR).Results. Our studies showed a pCR of 27.1% and a pPR of 70.9% . Clinically small sized tumors (2–5 cms) and Bloom Richardson’s grade 1 tumors showed a pCR. Mean age at presentation was 50.58 yrs. 79.2% of cases were invasive ductal carcinoma NOS; only 2.1% were invasive lobular carcinoma, their response to NAT being the same. There was no downgrading of the tumor grades after NAT. Ductal carcinoma in situ and lymphovascular invasion were found to be resistant to chemotherapy. The histopathological changes noted in the lymph nodes were similar to that found in the tumor bed.Discussion and Conclusion. From our study we conclude that histopathological examination of the tumor bed is the gold standard for assessing the chemotherapeutic tumor response. As previous studies have shown pCR can be used as a surrogate biomarker to assess the tumor response.

Biomarkers detected by proteomic analysis predicts breast cancer response to neoadjuvant chemotherapy

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 669-669
Author(s):  
D. Shen ◽  
J. He ◽  
J. Gornbein ◽  
Z. Chen ◽  
K. F. Faull ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Proteomic Analysis ◽  
Tumor Response ◽  
Classification Tree ◽  
Objective Assessment ◽  
Locally Advanced ◽  
Poor Responders ◽  
Protein Biomarkers ◽  
Response To Neoadjuvant Chemotherapy

669 Background: Neoadjuvant chemotherapy provides an excellent opportunity for objective assessment of treatment-induced tumor response and for studying biomarkers characteristic of therapy-induced tumor responses. Methods: Proteomic analysis of T3/T4 breast cancer was performed in patients with locally advanced breast cancer in a phase II clinical trial. The breast cancer specimen was obtained before and after four cycles of Taxotere/Carboplatin/±Herceptin treatment. Two proteomic approaches, SELDI mass spectrometry and Clontech Ab Microarray 500, were used to screen for protein biomarkers that predict response of breast cancer to chemotherapy. Results: Five tumors with pathologically complete response (pCR) and 29 tumors with various amounts of residual tumors (Non-pCR) were analyzed by SELDI-TOF using the NP 20 chip. The normalized mass signals were compared between pCR vs Non-pCR at each aligned location by Wilcoxon rank sum test. Statistically significant differences were found at 22 m/z locations using a liberal p <0.20 criterion. The best univariate predictor occurred at m/z 14960 (p=0.004), which correctly classified 5/5 pCR spectra (100%) and 24/29 Non-pCR spectra (83%). A multivariate classification tree developed using m/z 14960 and m/z 12138 intensities correctly classified all 34 spectra. Ab microarray analysis was performed on five pCR tumors and in five tumors with the largest residual cancer. The Internal Normalization Ratio (INR) was calculated and used to compare the difference of protein expression between the two groups. Eight differentially expressed protein biomarkers were selected with the criteria of a statistically significant (Student t, p<0.05) expression change of <0.77 or >1.3 fold. Three proteins (Tat-SF1, PYK2 and PTP1B) were higher, and five (E2F2, IL1b, FEN1, CDC37 and ACM1) were lower in tumors with pCR. The unsupervised hierarchical clustering of the 10 samples by these eight proteins completely separated the pCR tumors from the poor responders. Conclusions: Our study suggests that bothSELDImass spectrometry and antibody microarray may be used to predict the tumor response to neoadjuvant chemotherapy. Proteomic analysis may be useful in developing tailored chemotherapy for breast cancer. [Table: see text]

scholarly journals Association between mammographic features and response to neoadjuvant chemotherapy in locally advanced breast carcinoma

2014 ◽  
Vol 7 (4) ◽  
pp. 149-156 ◽  
Author(s):  
Carlos A. Castaneda ◽  
Raymundo Flores ◽  
Katerin Rojas ◽  
Claudio Flores ◽  
Miluska Castillo ◽  
...  
Keyword(s):  
Breast Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Locally Advanced ◽  
Advanced Breast ◽  
Response To Neoadjuvant Chemotherapy

Prognostic value of response assessed by RECIST and WHO criteria to neoadjuvant chemotherapy in locally advanced gastric cancer patients

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e15647-e15647
Author(s):  
S. R. Park ◽  
J. S. Lee ◽  
Y. W. Kim ◽  
I. J. Choi ◽  
K. W. Ryu ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Advanced Gastric Cancer ◽  
Tumor Size ◽  
Tumor Response ◽  
Locally Advanced ◽  
R0 Resection ◽  
Who Criteria ◽  
Locally Advanced Gastric Cancer ◽  
Response To Neoadjuvant Chemotherapy

e15647 Background: In metastatic gastric cancer, the response to chemotherapy is assessed by RECIST or WHO criteria according to the change of tumor size. There are no data, however, on the usefulness of those criteria in evaluating tumor response in the setting of neoadjuvant chemotherapy. The aim of this study was to evaluate the relationship between tumor response to neoadjuvant chemotherapy-as assessed by RECIST and WHO criteria-and clinical outcome in locally advanced gastric cancer (LAGC) patients. Methods: This study recruited LAGC patients who, from January 2003 through November 2005, entered the neoadjuvant arm of prospective randomized phase II trials comparing neoadjuvant chemotherapy to adjuvant chemotherapy. LAGC was defined as stage III or IV (M0) disease based on computed tomography (CT) according to the Japanese Classification of Gastric Carcinoma. Patients with measurable lesions received 3 cycles of neoadjuvant chemotherapy consisting of docetaxel (36 mg/m2) and cisplatin (40 mg/m2) on days 1 and 8 every 3 weeks, followed by surgery. Results: After chemotherapy, 40 (95%) patients underwent surgery and the remaining 2 patients showed new distant metastasis on CT scan. Thirty-five (83%) patients had curative R0 resection. Twenty-eight (67%) patients had a clinical response to neoadjuvant chemotherapy according to RECIST/WHO criteria. Although R0 resection rate (93% vs 64%, P = 0.03), median relapse-free survival (RFS) (43.2 vs 7.5 months, P = 0.14), and overall survival (OS) (not reached vs 27.0 months, P = 0.10) were better in responders than non-responders, they did not differ significantly in the subgroup that subsequently underwent surgery. When we redefined the decrease in tumor size judged as a response by RECIST (≥60% rather than ≥30%) and WHO (≥75% rather than ≥50%) criteria, response correlated significantly with both RFS (P = 0.03) and OS (P = 0.02). Conclusions: In the neoadjuvant setting, which frequently involves smaller measurable lesions than the metastatic setting, larger changes in tumor size than those specified by RECIST and WHO criteria are needed to predict postoperative outcome. No significant financial relationships to disclose.

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