Does complete radiological response correlate with a complete pathological response following neoadjuavant chemotherapy?
Association of Breast Surgery ePoster Library. Frost-Younger A. 05/13/19; 257178; P136
Alexander Frost-Younger
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Abstract
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P136
Topic: Other
Background: Neoadjuvant chemotherapy (NAC) is increasingly used to downstage cancers or for dual anti Her2 treatment prior to surgery. Response to NAC is monitored by imaging prior to and at completion of NAC, most commonly with magnetic resonance imaging (MRI). We assessed correlation of complete radiological and complete pathological response. Methods Retrospective data analysis from two breast screening institutions of all patients undergoing neoadjuvant chemotherapy from May 2014 to November 2017. All patients had MRI prior to and at completion of NAC. Results were excluded if they had missing data. Results158 patients were studied. Results are shown in the table below. Table 1: Comparison of complete and partial response in Pathology and Radiology, n(%) Table 1Complete radiological response (rCR)Partial radiological response (rPR)TotalComplete pathological response (pCR)34 2256 (35)Partial pathological response (pPR)20 82102 (65)Total54 (34)104 (66)15863% of cases with a rCR also had a pCR (34/54). Conversely, 39% of pCR patients (22/56) only had partial radiological resolution. ConclusionThe positive predictive value of MRI in this series was 61% in predicting complete pathological response, overall accuracy of MRI was 73%. However, imaging did not correlate with pCR in a significant number of cases. This should be considered when planning surgery following NAC.
Topic: Other
Background: Neoadjuvant chemotherapy (NAC) is increasingly used to downstage cancers or for dual anti Her2 treatment prior to surgery. Response to NAC is monitored by imaging prior to and at completion of NAC, most commonly with magnetic resonance imaging (MRI). We assessed correlation of complete radiological and complete pathological response. Methods Retrospective data analysis from two breast screening institutions of all patients undergoing neoadjuvant chemotherapy from May 2014 to November 2017. All patients had MRI prior to and at completion of NAC. Results were excluded if they had missing data. Results158 patients were studied. Results are shown in the table below. Table 1: Comparison of complete and partial response in Pathology and Radiology, n(%) Table 1Complete radiological response (rCR)Partial radiological response (rPR)TotalComplete pathological response (pCR)34 2256 (35)Partial pathological response (pPR)20 82102 (65)Total54 (34)104 (66)15863% of cases with a rCR also had a pCR (34/54). Conversely, 39% of pCR patients (22/56) only had partial radiological resolution. ConclusionThe positive predictive value of MRI in this series was 61% in predicting complete pathological response, overall accuracy of MRI was 73%. However, imaging did not correlate with pCR in a significant number of cases. This should be considered when planning surgery following NAC.
P136
Topic: Other
Background: Neoadjuvant chemotherapy (NAC) is increasingly used to downstage cancers or for dual anti Her2 treatment prior to surgery. Response to NAC is monitored by imaging prior to and at completion of NAC, most commonly with magnetic resonance imaging (MRI). We assessed correlation of complete radiological and complete pathological response. Methods Retrospective data analysis from two breast screening institutions of all patients undergoing neoadjuvant chemotherapy from May 2014 to November 2017. All patients had MRI prior to and at completion of NAC. Results were excluded if they had missing data. Results158 patients were studied. Results are shown in the table below. Table 1: Comparison of complete and partial response in Pathology and Radiology, n(%) Table 1Complete radiological response (rCR)Partial radiological response (rPR)TotalComplete pathological response (pCR)34 2256 (35)Partial pathological response (pPR)20 82102 (65)Total54 (34)104 (66)15863% of cases with a rCR also had a pCR (34/54). Conversely, 39% of pCR patients (22/56) only had partial radiological resolution. ConclusionThe positive predictive value of MRI in this series was 61% in predicting complete pathological response, overall accuracy of MRI was 73%. However, imaging did not correlate with pCR in a significant number of cases. This should be considered when planning surgery following NAC.
Topic: Other
Background: Neoadjuvant chemotherapy (NAC) is increasingly used to downstage cancers or for dual anti Her2 treatment prior to surgery. Response to NAC is monitored by imaging prior to and at completion of NAC, most commonly with magnetic resonance imaging (MRI). We assessed correlation of complete radiological and complete pathological response. Methods Retrospective data analysis from two breast screening institutions of all patients undergoing neoadjuvant chemotherapy from May 2014 to November 2017. All patients had MRI prior to and at completion of NAC. Results were excluded if they had missing data. Results158 patients were studied. Results are shown in the table below. Table 1: Comparison of complete and partial response in Pathology and Radiology, n(%) Table 1Complete radiological response (rCR)Partial radiological response (rPR)TotalComplete pathological response (pCR)34 2256 (35)Partial pathological response (pPR)20 82102 (65)Total54 (34)104 (66)15863% of cases with a rCR also had a pCR (34/54). Conversely, 39% of pCR patients (22/56) only had partial radiological resolution. ConclusionThe positive predictive value of MRI in this series was 61% in predicting complete pathological response, overall accuracy of MRI was 73%. However, imaging did not correlate with pCR in a significant number of cases. This should be considered when planning surgery following NAC.
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