%0 Journal Article
%T Which Imaging Modality Is Superior for Prediction of Response to Neoadjuvant Chemotherapy in Patients with Triple Negative Breast Cancer?
%A Jordan J. Atkins
%A Catherine M. Appleton
%A Carla S. Fisher
%A Feng Gao
%A Julie A. Margenthaler
%J Journal of Oncology
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/964863
%X Background and Objectives. Triple negative breast cancer (TNBC) has been shown to be generally chemosensitive. We sought to investigate the utility of mammography (MMG), ultrasonography (US), and breast magnetic resonance imaging (MRI) in predicting residual disease following neoadjuvant chemotherapy for TNBC. Methods. We identified 148 patients with 151 Stage I每III TNBC treated with neoadjuvant chemotherapy. Residual tumor size was estimated by MMG, US, and/or MRI prior to surgical intervention and compared to the subsequent pathologic residual tumor size. Data were compared using chi-squared test. Results. Of 151 tumors, 44 (29%) did not have imaging performed prior to surgical treatment. Thirty-eight (25%) tumors underwent a pathologic complete response (pCR), while 113 (75%) had residual invasive disease. The imaging modality was accurate to within 1ˋcm of the final pathologic residual disease in 74 (69%) cases and within 2ˋcm in 94 (88%) cases. Groups were similar with regards to patient age, race, tumor size and grade, and clinical stage ( ). Accuracy to within 1ˋcm was the highest for US (83%) and the lowest for MMG (56%) ( ). Conclusions. Breast US and MRI were more accurate than MMG in predicting residual tumor size following neoadjuvant chemotherapy in patients with TNBC. None of the imaging modalities were predictive of a pCR. 1. Introduction Breast cancer is the most common cancer in women in the USA, but it is a heterogeneous disease and treatment recommendations vary accordingly. The expressions of steroid hormone receptors such as estrogen receptor (ER) and progesterone receptor (PR), and the oncogene ErbB-2/human epidermal growth factor receptor 2 (HER-2) are important factors in distinguishing breast cancer subtypes. Triple negative breast cancer (TNBC), which is characterized by a lack of ER, PR, and HER-2 expressions, comprises approximately 11%每20% of all newly diagnosed breast cancers [1每5]. Previous studies demonstrate that patients with TNBC have a poorer outcome compared with other subtypes of breast cancer [1, 6每10]. The risk of recurrence for patients with TNBC peaks within the first 3 years following diagnosis and treatment, and the majority of deaths take place within the first 5 years after initial treatment [11每14]. Directed therapy options for treating TNBC are limited as these tumors lack a therapeutic target that can be treated with hormone therapy or trastuzumab. As a result, chemotherapy is the standard method used to treat these patients [15每17]. Although randomized studies of neoadjuvant versus adjuvant chemotherapy
%U http://www.hindawi.com/journals/jo/2013/964863/