How accurate is ultrasound scan in predicting the size of residual breast cancer following neoadjuvant chemotherapy?
Association of Breast Surgery ePoster Library. Pujji O. 05/13/19; 257134; P090
Ojas Pujji
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Abstract
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P090
Topic: Non surgical treatments
Introduction MRI is considered the imaging of choice to monitor response to neoadjuvant chemotherapy (NAC). However, MRI is costly and hence many hospitals use ultrasound scan (USS) instead. The aim of this study was to assess the accuracy of USS in predicting residual disease burden in our cohort of patients. Methods We studied 96 consecutive NAC patients. We then selected patients with unifocal disease. The largest diameter of residual breast disease reported on USS after NAC and the largest diameter reported on histology report on the excision specimen was noted. We divided patients into 4 groups of accuracy: ‘exact size' prediction, within ± 1cm, USS underestimating >1cm and USS overestimating >1cm. We also analysed if accuracy of USS correlated with number of days between scan and operation. Results: We had 43 patients with unifocal disease. USS correctly predicted complete response in 3/7 (43%) patients. USS predicted ‘exact size' of residual disease in 9% patients (n=4), within ± 1cm in 33% (n=14), underestimated>1cm in 33% (n=14) and overestimated > 1cm in 25% (n=11) patients. USS therefore accurately estimated the size of residual breast disease within a centimetre in 42% (18/43)patients. The number of days between USS scan and operation had minimal bearing on accuracy.ConclusionUSS will be accurate in predicting residual disease burden within a centimetre in only 2 out of 5 patients while underestimating the residual size by >1cm in nearly 1 in 3 patients. This should be kept in mind when planning surgery and counselling patients for surgery.
Topic: Non surgical treatments
Introduction MRI is considered the imaging of choice to monitor response to neoadjuvant chemotherapy (NAC). However, MRI is costly and hence many hospitals use ultrasound scan (USS) instead. The aim of this study was to assess the accuracy of USS in predicting residual disease burden in our cohort of patients. Methods We studied 96 consecutive NAC patients. We then selected patients with unifocal disease. The largest diameter of residual breast disease reported on USS after NAC and the largest diameter reported on histology report on the excision specimen was noted. We divided patients into 4 groups of accuracy: ‘exact size' prediction, within ± 1cm, USS underestimating >1cm and USS overestimating >1cm. We also analysed if accuracy of USS correlated with number of days between scan and operation. Results: We had 43 patients with unifocal disease. USS correctly predicted complete response in 3/7 (43%) patients. USS predicted ‘exact size' of residual disease in 9% patients (n=4), within ± 1cm in 33% (n=14), underestimated>1cm in 33% (n=14) and overestimated > 1cm in 25% (n=11) patients. USS therefore accurately estimated the size of residual breast disease within a centimetre in 42% (18/43)patients. The number of days between USS scan and operation had minimal bearing on accuracy.ConclusionUSS will be accurate in predicting residual disease burden within a centimetre in only 2 out of 5 patients while underestimating the residual size by >1cm in nearly 1 in 3 patients. This should be kept in mind when planning surgery and counselling patients for surgery.
P090
Topic: Non surgical treatments
Introduction MRI is considered the imaging of choice to monitor response to neoadjuvant chemotherapy (NAC). However, MRI is costly and hence many hospitals use ultrasound scan (USS) instead. The aim of this study was to assess the accuracy of USS in predicting residual disease burden in our cohort of patients. Methods We studied 96 consecutive NAC patients. We then selected patients with unifocal disease. The largest diameter of residual breast disease reported on USS after NAC and the largest diameter reported on histology report on the excision specimen was noted. We divided patients into 4 groups of accuracy: ‘exact size' prediction, within ± 1cm, USS underestimating >1cm and USS overestimating >1cm. We also analysed if accuracy of USS correlated with number of days between scan and operation. Results: We had 43 patients with unifocal disease. USS correctly predicted complete response in 3/7 (43%) patients. USS predicted ‘exact size' of residual disease in 9% patients (n=4), within ± 1cm in 33% (n=14), underestimated>1cm in 33% (n=14) and overestimated > 1cm in 25% (n=11) patients. USS therefore accurately estimated the size of residual breast disease within a centimetre in 42% (18/43)patients. The number of days between USS scan and operation had minimal bearing on accuracy.ConclusionUSS will be accurate in predicting residual disease burden within a centimetre in only 2 out of 5 patients while underestimating the residual size by >1cm in nearly 1 in 3 patients. This should be kept in mind when planning surgery and counselling patients for surgery.
Topic: Non surgical treatments
Introduction MRI is considered the imaging of choice to monitor response to neoadjuvant chemotherapy (NAC). However, MRI is costly and hence many hospitals use ultrasound scan (USS) instead. The aim of this study was to assess the accuracy of USS in predicting residual disease burden in our cohort of patients. Methods We studied 96 consecutive NAC patients. We then selected patients with unifocal disease. The largest diameter of residual breast disease reported on USS after NAC and the largest diameter reported on histology report on the excision specimen was noted. We divided patients into 4 groups of accuracy: ‘exact size' prediction, within ± 1cm, USS underestimating >1cm and USS overestimating >1cm. We also analysed if accuracy of USS correlated with number of days between scan and operation. Results: We had 43 patients with unifocal disease. USS correctly predicted complete response in 3/7 (43%) patients. USS predicted ‘exact size' of residual disease in 9% patients (n=4), within ± 1cm in 33% (n=14), underestimated>1cm in 33% (n=14) and overestimated > 1cm in 25% (n=11) patients. USS therefore accurately estimated the size of residual breast disease within a centimetre in 42% (18/43)patients. The number of days between USS scan and operation had minimal bearing on accuracy.ConclusionUSS will be accurate in predicting residual disease burden within a centimetre in only 2 out of 5 patients while underestimating the residual size by >1cm in nearly 1 in 3 patients. This should be kept in mind when planning surgery and counselling patients for surgery.
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