| Title |
MRI predicts pathologic complete response in HER2-positive breast cancer after neoadjuvant chemotherapy
|
|---|---|
| Published in |
Breast Cancer Research and Treatment, April 2017
|
| DOI | 10.1007/s10549-017-4254-0 |
| Pubmed ID | |
| Authors |
Mette S. van Ramshorst, Claudette E. Loo, Emilie J. Groen, Gonneke H. Winter-Warnars, Jelle Wesseling, Frederieke van Duijnhoven, Marie-Jeanne T. Vrancken Peeters, Gabe S. Sonke |
| Abstract |
Neoadjuvant treatment of HER2-positive breast cancer frequently leads to a pathologic complete response (pCR), which is associated with favourable long-term outcome. Treatment regimens typically consist of 6-9 cycles of trastuzumab-based chemotherapy, although many patients achieve early radiologic complete response (rCR). If rCR accurately predicts pCR, the number of chemotherapy cycles can possibly be reduced. We performed a diagnostic accuracy study to determine the association between rCR and pCR in patients with stage II-III HER2-positive breast cancer treated with neoadjuvant trastuzumab-based chemotherapy at the Netherlands Cancer Institute. RCR was defined as the disappearance of pathologic contrast enhancement in the original tumour region on repeated magnetic resonance imaging (MRI). PCR was defined as the absence of invasive tumour cells in the resected breast specimen (ypT0/is). Diagnostic accuracy was estimated in the overall population and in subgroups based on hormone receptor (HR) status. The prognostic value of rCR for recurrence-free interval was evaluated as an exploratory analysis. We identified 296 eligible patients with 297 HER2-positive tumours (154 HR-negative and 143 HR-positive) treated with neoadjuvant trastuzumab-based chemotherapy between 2004 and 2016. Overall, the rCR rate was 69% (206/297) and the pCR rate was 61% (181/297). Among 206 patients with rCR, 150 also had pCR (negative predictive value [NPV] = 150/206 = 73%). Among 91 patients without rCR, 60 had residual tumour at pathology (positive predictive value [PPV] = 60/91 = 66%). The NPV was better in HR-negative compared to HR-positive tumours (88 vs. 57%), while the PPV was better in HR-positive tumours (50 vs. 78%). Achieving rCR was associated with a 5-year recurrence-free interval of 88% compared to 68% without rCR (hazard ratio 0.34, 95% confidence interval 0.17-0.65, P = 0.001). Achieving rCR corresponds well with pCR in HER2-positive breast cancer, particularly in the HR-negative subgroup. RCR is also associated with improved long-term outcome. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 53 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 53 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 19% |
| Student > Ph. D. Student | 7 | 13% |
| Other | 6 | 11% |
| Student > Bachelor | 5 | 9% |
| Student > Master | 5 | 9% |
| Other | 8 | 15% |
| Unknown | 12 | 23% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 24 | 45% |
| Engineering | 3 | 6% |
| Nursing and Health Professions | 3 | 6% |
| Agricultural and Biological Sciences | 2 | 4% |
| Mathematics | 1 | 2% |
| Other | 6 | 11% |
| Unknown | 14 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 April 2017.
All research outputs
#20,414,746
of 22,965,074 outputs
Outputs from Breast Cancer Research and Treatment
#4,122
of 4,673 outputs
Outputs of similar age
#269,625
of 309,877 outputs
Outputs of similar age from Breast Cancer Research and Treatment
#83
of 110 outputs
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