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For: Ojeda-Fournier H, de Guzman J, Hylton N. Breast Magnetic Resonance Imaging for Monitoring Response to Therapy. Magn Reson Imaging Clin N Am 2013;21:533-46. [DOI: 10.1016/j.mric.2013.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]

For:	Ojeda-Fournier H, de Guzman J, Hylton N. Breast Magnetic Resonance Imaging for Monitoring Response to Therapy. Magn Reson Imaging Clin N Am 2013;21:533-46. [DOI: 10.1016/j.mric.2013.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]

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Cited by Other Article(s)

Partridge SC, Zhang Z, Newitt DC, Gibbs JE, Chenevert TL, Rosen MA, Bolan PJ, Marques HS, Romanoff J, Cimino L, Joe BN, Umphrey HR, Ojeda-Fournier H, Dogan B, Oh K, Abe H, Drukteinis JS, Esserman LJ, Hylton NM. Diffusion-weighted MRI Findings Predict Pathologic Response in Neoadjuvant Treatment of Breast Cancer: The ACRIN 6698 Multicenter Trial. Radiology 2018;289:618-627. [PMID: 30179110 PMCID: PMC6283325 DOI: 10.1148/radiol.2018180273] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 07/12/2018] [Accepted: 07/18/2018] [Indexed: 01/06/2023]

Abstract

Purpose To determine if the change in tumor apparent diffusion coefficient (ADC) at diffusion-weighted (DW) MRI is predictive of pathologic complete response (pCR) to neoadjuvant chemotherapy for breast cancer. Materials and Methods In this prospective multicenter study, 272 consecutive women with breast cancer were enrolled at 10 institutions (from August 2012 to January 2015) and were randomized to treatment with 12 weekly doses of paclitaxel (with or without an experimental agent), followed by 12 weeks of treatment with four cycles of anthracycline. Each woman underwent breast DW MRI before treatment, at early treatment (3 weeks), at midtreatment (12 weeks), and after treatment. Percentage change in tumor ADC from that before treatment (ΔADC) was measured at each time point. Performance for predicting pCR was assessed by using the area under the receiver operating characteristic curve (AUC) for the overall cohort and according to tumor hormone receptor (HR)/human epidermal growth factor receptor 2 (HER2) disease subtype. Results The final analysis included 242 patients with evaluable serial imaging data, with a mean age of 48 years ± 10 (standard deviation); 99 patients had HR-positive (hereafter, HR+)/HER2-negative (hereafter, HER2-) disease, 77 patients had HR-/HER2- disease, 42 patients had HR+/HER2+ disease, and 24 patients had HR-/HER2+ disease. Eighty (33%) of 242 patients experienced pCR. Overall, ΔADC was moderately predictive of pCR at midtreatment/12 weeks (AUC = 0.60; 95% confidence interval [CI]: 0.52, 0.68; P = .017) and after treatment (AUC = 0.61; 95% CI: 0.52, 0.69; P = .013). Across the four disease subtypes, midtreatment ΔADC was predictive only for HR+/HER2- tumors (AUC = 0.76; 95% CI: 0.62, 0.89; P < .001). In a test subset, a model combining tumor subtype and midtreatment ΔADC improved predictive performance (AUC = 0.72; 95% CI: 0.61, 0.83) over ΔADC alone (AUC = 0.57; 95% CI: 0.44, 0.70; P = .032.). Conclusion After 12 weeks of therapy, change in breast tumor apparent diffusion coefficient at MRI predicts complete pathologic response to neoadjuvant chemotherapy. © RSNA, 2018 Online supplemental material is available for this article.

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Affiliation(s)

Savannah C. Partridge From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Zheng Zhang From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
David C. Newitt From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Jessica E. Gibbs From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Thomas L. Chenevert From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Mark A. Rosen From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Patrick J. Bolan From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Helga S. Marques From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Justin Romanoff From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Lisa Cimino From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Bonnie N. Joe From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Heidi R. Umphrey From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Haydee Ojeda-Fournier From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Basak Dogan From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Karen Oh From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Hiroyuki Abe From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Jennifer S. Drukteinis From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Laura J. Esserman From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
Nola M. Hylton From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)
For the ACRIN 6698 Trial Team and I-SPY 2 Trial Investigators From the Department of Radiology, University of Washington, 825 Eastlake Ave E, G2-600, Seattle, WA 98109 (S.C.P.); Department of Biostatistics (Z.Z.) and Center for Statistical Sciences (Z.Z., H.S.M., J.R.), Brown University, Providence, RI; American College of Radiology Imaging Network (ACRIN), Reston, Va (Z.Z., H.S.M., J.R.); Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, Calif (D.C.N., J.E.G., B.N.J., L.J.E., N.M.H.); Department of Radiology/MRI, University of Michigan, Ann Arbor, Mich (T.L.C.); Department of Radiology, University of Pennsylvania, Philadelphia, Pa (M.A.R.); Department of Radiology, Center for Magnetic Resonance Research, University of Minnesota, Minneapolis, Minn (P.J.B.); American College of Radiology and ECOG-ACRIN Cancer Research Group, Reston, Va (L.C.); Department of Radiology, University of Alabama, Birmingham, Birmingham, Ala (H.R.U.); Department of Radiology, University of California, San Diego, San Diego, Calif (H.O.); Department of Radiology, University of Texas MD Anderson Cancer Center, Houston, Tex and the University of Texas Southwestern Medical Center, Dallas, Tex (B.D.); Department of Radiology, Oregon Health and Science University, Portland, Ore (K.O.); Department of Radiology, University of Chicago, Chicago, Ill (H.A.); and Department of Diagnostic Radiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla and Department of Women’s Imaging, St Joseph’s Women’s Hospital, Tampa, Fla (J.S.D.)

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New challenges in multimodal workout of locally advanced breast cancer. Surgeon 2017. [PMID: 28624359 DOI: 10.1016/j.surge.2017.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]

Joe BN, Sickles EA. The evolution of breast imaging: past to present. Radiology 2015;273:S23-44. [PMID: 25340437 DOI: 10.1148/radiol.14141233] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]

Bonev V, Evangelista M, Chen JH, Su MY, Lane K, Mehta R, Butler J, Hsiang D. Long-term Follow-up of Breast-conserving Therapy in Patients with Inflammatory Breast Cancer Treated with Neoadjuvant Chemotherapy. Am Surg 2014. [DOI: 10.1177/000313481408001006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]

Fontein DBY, Charehbili A, Nortier JWR, Meershoek-Klein Kranenbarg E, Kroep JR, Putter H, van Riet Y, Nieuwenhuijzen GAP, de Valk B, Terwogt JMM, Algie GD, Liefers GJ, Linn S, van de Velde CJH. Efficacy of six month neoadjuvant endocrine therapy in postmenopausal, hormone receptor-positive breast cancer patients--a phase II trial. Eur J Cancer 2014;50:2190-200. [PMID: 24970786 DOI: 10.1016/j.ejca.2014.05.010] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2014] [Revised: 03/24/2014] [Accepted: 05/08/2014] [Indexed: 12/23/2022]

Abstract

BACKGROUND

Neoadjuvant hormonal therapy (NHT) is playing an increasing role in the clinical management of breast cancer (BC) and may improve surgical outcomes for postmenopausal, oestrogen receptor (ER)-positive BC patients. However, there is currently no consensus on the optimal duration of NHT before surgery. Here, we present the outcomes of the TEAM IIA trial, a multicentre, phase II trial investigating the efficacy of six months of neoadjuvant exemestane in postmenopausal, strong ER-positive (ER+, ⩾50%) BC patients.

METHODS

102 patients (stage T2-T4ac) were included in the study after exclusion of ineligible patients. Primary end-point was clinical response at 3 and 6 months as measured by palpation. Secondary end-point was radiological response as measured by magnetic resonance imaging (MRI), mammography and/or ultrasound. Linear mixed models (95% confidence interval (CI)) were used to compare changes in mean tumour size (in mm) between baseline, 3 and 6 months after the start of endocrine therapy. Conversion rates from mastectomy to breast conserving surgery (BCS) were evaluated.

RESULTS

Median age of all patients was 72 years (range 53-88). Overall response rate by clinical palpation was 64.5% in all patients with a final palpation measurement. Four patients had clinically progressive disease. 63 patients had both 3-month and >3-month palpation measurements. Overall response was 58.7% at 3 months and 68.3% at final palpation (>3 months). Mean tumour size by clinical palpation at T=0 was 39.1mm (95% CI 34.8-43.4mm), and decreased to 23.0mm (95% CI 18.7-27.2mm) and 16.7 mm (95% CI 12.6-20.8) at T=3 and T>3 months, respectively (p=0.001). Final radiological response rates at the end of treatment for MRI (n=37), ultrasound (n=77) and mammography (n=56) were 70.3%, 41.6% and 48.2%, respectively. Feasibility of BCS improved from 61.8% to 70.6% (McNemar p=0.012).

CONCLUSION

6 months of neoadjuvant exemestane therapy helps reduce mean tumour size further in strongly ER-positive BC patients without significant side-effects compared to 3 months. Nevertheless, some patients still experience disease progression under exemestane. Feasibility of breast conservation rates improved by almost 10%.

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