Assessment of pathological response of breast cancer in patients undergoing neoadjuvant chemotherapy in a refferal hospital in Amazonas State

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DOI:

https://doi.org/10.29289/2594539420230002

Palavras-chave:

mammography, ultrasound, clinical examination, neoadjuvant chemotherapy

Resumo

Introduction: The therapeutic options for breast cancer are diverse. Increasingly, treatments are established on an individual basis, depending on a series of variables ranging from age to the molecular profile of the tumor. When neoadjuvant chemotherapy (NAC) is necessary, adequate clinical evaluation (CE) and control examinations, such as breast ultrasound (US) and mammography (MMG), are of fundamental importance, as it is necessary to reevaluate the tumor lesion to determine an individualized surgical treatment, with the aim of performing breast-conserving surgery within the available techniques. This study sought to evaluate the pathological response of patients undergoing neoadjuvant chemotherapy, analyzing the presence or absence of tumor reduction by relating the physical examination with imaging methods (MMG and US), taking the anatomopathological examination measurements as the gold standard, thus intending to identify the best method for evaluating the pathological response. Methods: This was a prospective, observational, analytical cohort study. The study included 41 patients diagnosed with breast cancer detected by mammography and ultrasound (MMG and US) followed by biopsy, who underwent neoadjuvant chemotherapy (NAC) and surgery. The measurements of the malignant breast lesions obtained by CE, MMG and US were compared with the anatomopathological measurements on biopsy as the gold standard. Results: Pearson's correlation coefficient was the statistical method used for evaluation, finding a value of 0.49 between the anatomopathological examination and CE, 0.47 between the anatomopathological examination and MMG and 0.48 between the anatomopathological examination and US (p<0.05). Conclusions: CE, MMG and US showed a moderate correlation with anatomopathological measurement, in addition to a moderate correlation between them, demonstrating equivalence in the pre-surgical definition of the size of the breast tumor after NAC, being complementary to each other to define a measure of greater accuracy of the tumor in breast cancer.

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Referências

Instituto Nacional de Câncer José Alencar Gomes da Silva. A situação do câncer de mama no Brasil: síntese de dados dos sistemas de informação. Rio de Janeiro: INCA; 2019.

Instituto Nacional de Câncer José Alencar Gomes da Silva. Estimativa 2023: incidência de câncer no Brasil. Rio de Janeiro: INCA; 2022.

Instituto Nacional do Câncer José Alencar Gomes da Silva. Estimativa Estado-Capital (Amazonas-Manaus) [Internet]. [cited on 2022 Oct 23]. Available from: https://www.inca.gov.br/estimativa/estado-capital/amazonas-manaus

Instituto Nacional de Câncer. Coordenação de Prevenção e Vigilância. Divisão de Detecção Precoce e Apoio à Organização de Rede. Dados e números sobre câncer de mama. Relatório anual 2022 [Internet]. [cited on 2022 Oct 23]. Available from: https://www.inca.gov.br/sites/ufu.sti.inca.local/files/media/document/dados_e_numeros_site_cancer_mama_setembro2022.pdf

Paris JF, Cimato G, Rolla EM, Saravia Toledo JA, León M, Salmoral L, et al. ¿Son el examen clínico, la mamografía y la ecografía métodos confiables para la valoración del tumor residual posterior a neoadyuvancia? Rev Argent Mastología. 2017;36(131):50-63.

Cortadellas T, Argacha P, Acosta J, Rabasa J, Peiró R, Gomez M, et al. Estimation of tumor size in breast cancer comparing clinical examination, mammography, ultrasound and MRI-correlation with the pathological analysis of the surgical specimen. Gland Surg. 2017;6(4):330-5. https://doi.org/10.21037/gs.2017.03.09

Zhang C, Kosiorek HE, Patel BK, Pockaj BA, Ahmad SB, Cronin PA. Accuracy of

posttreatment imaging for evaluation of residual in breast disease after neoadjuvant endocrine therapy. Ann Surg Oncol. 2022;29(10):6207-12. https://doi.org/10.1245/s10434-022-12128-5

Kaise H, Shimizu F, Akazawa K, Hasegawa Y, Horiguchi J, Miura D, et al. Prediction of pathological response to neoadjuvant chemotherapy in breast cancerpatients by imaging. J Surg Res. 2018;225:175-80. https://doi.org/10.1016/j.jss.2017.12.002

Murakami R, Tani H, Kumita S, Uchiyama N. Diagnostic performance of digital breast tomosynthesis for predicting response to neoadjuvant systemic therapy in breast

cancer patients: a comparison with magnetic resonance imaging, ultrasound, and full- field digital mammography. Acta Radiol Open. 2021;10(12):20584601211063746. https://doi.org/10.1177/20584601211063746

Scheel JR, Kim E, Partridge SC, Lehman CD, Rosen MA, Bernreuter WK, et al. MRI, clinical examination, and mammography for preoperative assessment of residual disease and pathologic complete response after neoadjuvant chemotherapy for breast cancer: ACRIN 6657 Trial. AJR Am J Roentgenol. 2018;210(6):1376-85. https://doi.org/10.2214/AJR.17.18323

Park J, Chae EY, Cha JH, Shin HJ, Choi WJ, Choi YW, et al. Comparison of mammography, digital breast tomosynthesis, automated breast ultrasound, magnetic resonance imaging in evaluation of residual tumor after neoadjuvant chemotherapy. Eur J Radiol. 2018;108:261-8. https://doi.org/10.1016/j.ejrad.2018.09.032

Rauch GM, Kuerer HM, Adrada B, Santiago L, Moseley T, Candelaria RP, et al. Biopsy feasibility trial for breast cancer pathologic complete response detection after neoadjuvant chemotherapy: imaging assessment and correlation endpoints. Ann Surg Oncol. 2018;25(7):1953-60. https://doi.org/10.1245/s10434-018-6481-y

Makanjuola DI, Alkushi A, Al Anazi K. Defining radiologic complete response using a correlation of presurgical ultrasound and mammographic localization findings with pathological complete response following neoadjuvant chemotherapy in breast cancer. Eur J Radiol. 2020;130:109146. https://doi.org/10.1016/j.ejrad.2020.109146

Jones EF, Hathi DK, Freimanis R, Mukhtar RA, Chien AJ, Esserman LJ, et al. Current landscape of breast cancer imaging and potential quantitative imaging markers

of response in er-positive breast cancers treated with neoadjuvant therapy. Cancers (Basel). 2020;12(6):1511. https://doi.org/10.3390/cancers12061511

Sudhir R, Koppula VC, Rao TS, Sannapareddy K, Rajappa SJ, Murthy SS. Accuracy of digital mammography, ultrasound and MRI in predicting the pathological complete response and residual tumor size of breast cancer after completion of neoadjuvant chemotherapy. Indian J Cancer. 2022;59(3):345-53. https://doi.org/10.4103/ijc.IJC_795_19

Siqueira FMP, Rezende CAL, Barra AA. Correlação entre o exame clínico, a mamografia e a ultra-sonografia com o exame anatomopatológico na determinação do tamanho tumoral no câncer de mama. Rev Bras Ginecol Obstet. 2008;30(3):107-12. https://doi.org/10.1590/S0100-72032008005000005

Cuesta Cuesta AB, Martín Ríos MD, Noguero Meseguer MR, García Velasco JA, de Matías Martínez M, Bartolomé Sotillos S, et al. Accuracy of tumor size measurements performed by magnetic resonance, ultrasound and mammography, and their correlation with pathological size in primary breast cancer. Cir Esp (Engl Ed). 2019;97(7):391-6. https://doi.org/10.1016/j.ciresp.2019.04.017

Siegel RL, Miller KD, Jemal A. Cancer statistics, 2020. CA Cancer J Clin. 2020;70(1):7-30. https://doi.org/10.3322/caac.21590

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Publicado

2024-10-11

Como Citar

Pacheco, K. C. X. ., Pereira, G. V. ., Silva, H. A. de M. e ., Pereira, H. V. ., Becil, J. N. ., Oliveira, K. F. de ., … Pereira, H. F. B. do E. S. A. . (2024). Assessment of pathological response of breast cancer in patients undergoing neoadjuvant chemotherapy in a refferal hospital in Amazonas State. Mastology, 34. https://doi.org/10.29289/2594539420230002

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Original Articles