Magnetic resonance imaging and ultrasound for prediction of residual tumor size in early breast cancer within the ADAPT subtrials.

Abstract

BACKGROUND:

Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes.

METHODS:

Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values.

RESULTS:

A total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by < 10 mm in 4.4% and 21.8% of patients by MRI and in 10.2% and 15.8% by ultrasound. Overall, NPV (proportion of correctly predicted tumor size ≤10 mm) of MRI and ultrasound was 0.92 and 0.83; PPV (correctly predicted tumor size > 10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR-/HER2+ tumors. Both methods had a comparable NPV and PPV in HR-/HER2- tumors.

CONCLUSIONS:

In HR+/HER2+ and HR-/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT.

TRIAL REGISTRATION:

Clinicaltrials.gov , NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).

• Authors: Monika Graeser, Simone Schrading, Oleg Gluz, Kevin Strobel, Christopher Herzog, Lale Umutlu, Alex Frydrychowicz, Dorothea Rjosk-Dendorfer, Rachel Würstlein, Ralph Culemann, Christine Eulenburg, Jascha Adams, Henrik Nitzsche, Anna Prange, Sherko Kümmel, Eva-Maria Grischke, Helmut Forstbauer, Michael Braun, Jochem Potenberg, Raquel von Schumann, Bahriye Aktas, Cornelia Kolberg-Liedtke, Nadia Harbeck, Christiane K Kuhl, Ulrike Nitz
• Journal: Breast cancer research : BCR (Breast Cancer Res) Vol. 23 Issue 1 Pg. 36 (03 18 2021) ISSN: 1465-542X [Electronic] England
• PMID: 33736679 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Receptors, Estrogen
• Receptors, Progesterone
• ERBB2 protein, human
• Receptor, ErbB-2

Topics

• Adult
• Aged
• Breast Neoplasms (diagnostic imaging, drug therapy, metabolism, pathology)
• Female
• Humans
• Magnetic Resonance Imaging
• Middle Aged
• Neoadjuvant Therapy
• Neoplasm, Residual
• Predictive Value of Tests
• Receptor, ErbB-2 (metabolism)
• Receptors, Estrogen (metabolism)
• Receptors, Progesterone (metabolism)
• Tumor Burden
• Ultrasonography, Mammary