Bibliographic Details
| Title: |
Disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and molecular subtype: prediction of axillary treatment response after neoadjuvant systemic therapy for breast cancer. |
| Authors: |
van Amstel, Florien J G, de Mooij, Cornelis M, Simons, Janine M, Mitea, Cristina, van Diest, Paul J, Nelemans, Patty J, van der Pol, Carmen C, Luiten, Ernest J T, Koppert, Linetta B, Smidt, Marjolein L, van Nijnatten, Thiemo J A, de Beer, L, Boerma, E G, Boskamp, M, Brouwers-Kuyper, E M J, Contant, C M E, du Mée, A W F, Heijmans, H J, Ho-Han, S, Hulsebosch, F |
| Source: |
British Journal of Surgery; Sep2024, Vol. 111 Issue 9, p1-6, 6p |
| Subject Terms: |
EPIDERMAL growth factor receptors, SENTINEL lymph node biopsy, NEOADJUVANT chemotherapy, IODINE isotopes, LOGISTIC regression analysis, HORMONE receptor positive breast cancer |
| Abstract: |
Background: Axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT combined with pathological axillary treatment response has been proposed to guide de-escalation of axillary treatment for clinically node-positive breast cancer patients treated with neoadjuvant systemic therapy. The aim of this study was to assess whether axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and breast cancer molecular subtype are predictors of axillary pCR. Methods: This study included clinically node-positive patients treated with neoadjuvant systemic therapy in the prospective Radioactive Iodine Seed placement in the Axilla with Sentinel lymph node biopsy ('RISAS') trial (NCT02800317) with baseline [18F]fluorodeoxyglucose PET/CT imaging available. The predictive value of axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and breast cancer molecular subtype to estimate axillary pCR was evaluated using logistic regression analysis. Discriminative ability is expressed using ORs with 95% confidence intervals. Results: Overall, 185 patients were included, with an axillary pCR rate of 29.7%. The axillary pCR rate for patients with limited versus advanced baseline axillary disease according to [18F]fluorodeoxyglucose PET/CT was 31.9% versus 26.1% respectively. Axillary disease extent was not a significant predictor of axillary pCR (OR 0.75 (95% c.i. 0.38 to 1.46) (P = 0.404)). There were significant differences in axillary pCR rates between breast cancer molecular subtypes. The lowest probability (7%) was found for hormone receptor+/human epidermal growth factor receptor 2− tumours. Using this category as a reference group, significantly increased ORs of 14.82 for hormone receptor+/human epidermal growth factor receptor 2+ tumours, 40 for hormone receptor−/human epidermal growth factor receptor 2+ tumours, and 6.91 for triple-negative tumours were found (P < 0.001). Conclusion: Molecular subtype is a significant predictor of axillary pCR after neoadjuvant systemic therapy, whereas axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT is not. Molecular subtype is a significant predictor of axillary pCR, whereas axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT is not. Therefore, information on molecular subtype might be considered in guiding axillary treatment for clinically node-positive breast cancer patients treated with neoadjuvant systemic therapy. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
