Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques

Joerg Heil; Sherko Kümmel; Benedikt Schaefgen; Stefan Paepke; Christoph Thomssen; Geraldine Rauch; Beyhan Ataseven; Regina Große; Volker Dreesmann; Thorsten Kühn; Sibylle Loibl; Jens-Uwe Blohmer; Gunter von Minckwitz

doi:10.1038/bjc.2015.381

Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques

Standard

Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques. / Heil, Joerg; Kümmel, Sherko; Schaefgen, Benedikt; Paepke, Stefan; Thomssen, Christoph; Rauch, Geraldine; Ataseven, Beyhan; Große, Regina; Dreesmann, Volker; Kühn, Thorsten; Loibl, Sibylle; Blohmer, Jens-Uwe; von Minckwitz, Gunter.

In: BRIT J CANCER, Vol. 113, No. 11, 01.12.2015, p. 1565-1570.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Heil, J, Kümmel, S, Schaefgen, B, Paepke, S, Thomssen, C, Rauch, G, Ataseven, B, Große, R, Dreesmann, V, Kühn, T, Loibl, S, Blohmer, J-U & von Minckwitz, G 2015, 'Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques', BRIT J CANCER, vol. 113, no. 11, pp. 1565-1570. https://doi.org/10.1038/bjc.2015.381

APA

Heil, J., Kümmel, S., Schaefgen, B., Paepke, S., Thomssen, C., Rauch, G., Ataseven, B., Große, R., Dreesmann, V., Kühn, T., Loibl, S., Blohmer, J-U., & von Minckwitz, G. (2015). Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques. BRIT J CANCER, 113(11), 1565-1570. https://doi.org/10.1038/bjc.2015.381

Vancouver

Heil J, Kümmel S, Schaefgen B, Paepke S, Thomssen C, Rauch G et al. Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques. BRIT J CANCER. 2015 Dec 1;113(11):1565-1570. https://doi.org/10.1038/bjc.2015.381

Bibtex

@article{93dd922aafa040b69232916a9b6c00a5,

title = "Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques",

abstract = "BACKGROUND: Neoadjuvant chemotherapy (NACT) is widely used as an efficient breast cancer treatment. Ideally, a pathological complete response (pCR) can be achieved. Up to date, there is no reliable way of predicting a pCR. For the first time, we explore the ability of minimal invasive biopsy (MIB) techniques to diagnose pCR in patients with clinical complete response (cCR) to NACT in this study. This question is of high clinical relevance because a reliable pCR prediction could have direct implications for clinical practice.METHODS: In all, 164 patients were included in this review-board approved, multicenter pooled analysis of prospectively assembled data. Core-cut (CC)-MIB or vacuum-assisted (VAB)-MIB were performed after NACT and before surgery. Negative predictive values (NPV) and false-negative rates (FNR) to predict a pCR in surgical specimen (diagnose pCR through MIB) were the main outcome measures.RESULTS: Pathological complete response in surgical specimen was diagnosed in 93 (56.7%) cases of the whole cohort. The NPV of the MIB diagnosis of pCR was 71.3% (95% CI: (63.3%; 79.3%)). The FNR was 49.3% (95% CI: (40.4%; 58.2%)). Existence of a clip marker tended to improve the NPV (odds ratio 1.98; 95% CI: (0.81; 4.85)). None of the mammographically guided VABs (n=16) was false-negative (FNR 0%, NPV 100%).CONCLUSIONS: Overall accuracy of MIB diagnosis of pCR was insufficient to suggest changing clinical practice. However, subgroup analyses (mammographically guided VABs) suggest a potential capacity of MIB techniques to precisely diagnose pCR after NACT. Representativity of MIB could be a crucial factor to be focused on in further analyses.",

keywords = "Adult, Aged, Breast, Breast Neoplasms, Chemotherapy, Adjuvant, False Negative Reactions, Female, Humans, Image-Guided Biopsy, Middle Aged, Neoadjuvant Therapy, Predictive Value of Tests, Retrospective Studies, Treatment Outcome, Journal Article, Multicenter Study",

author = "Joerg Heil and Sherko K{\"u}mmel and Benedikt Schaefgen and Stefan Paepke and Christoph Thomssen and Geraldine Rauch and Beyhan Ataseven and Regina Gro{\ss}e and Volker Dreesmann and Thorsten K{\"u}hn and Sibylle Loibl and Jens-Uwe Blohmer and {von Minckwitz}, Gunter",

year = "2015",

month = dec,

day = "1",

doi = "10.1038/bjc.2015.381",

language = "English",

volume = "113",

pages = "1565--1570",

journal = "BRIT J CANCER",

issn = "0007-0920",

publisher = "NATURE PUBLISHING GROUP",

number = "11",

}

RIS

TY - JOUR

T1 - Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques

AU - Heil, Joerg

AU - Kümmel, Sherko

AU - Schaefgen, Benedikt

AU - Paepke, Stefan

AU - Thomssen, Christoph

AU - Rauch, Geraldine

AU - Ataseven, Beyhan

AU - Große, Regina

AU - Dreesmann, Volker

AU - Kühn, Thorsten

AU - Loibl, Sibylle

AU - Blohmer, Jens-Uwe

AU - von Minckwitz, Gunter

PY - 2015/12/1

Y1 - 2015/12/1

N2 - BACKGROUND: Neoadjuvant chemotherapy (NACT) is widely used as an efficient breast cancer treatment. Ideally, a pathological complete response (pCR) can be achieved. Up to date, there is no reliable way of predicting a pCR. For the first time, we explore the ability of minimal invasive biopsy (MIB) techniques to diagnose pCR in patients with clinical complete response (cCR) to NACT in this study. This question is of high clinical relevance because a reliable pCR prediction could have direct implications for clinical practice.METHODS: In all, 164 patients were included in this review-board approved, multicenter pooled analysis of prospectively assembled data. Core-cut (CC)-MIB or vacuum-assisted (VAB)-MIB were performed after NACT and before surgery. Negative predictive values (NPV) and false-negative rates (FNR) to predict a pCR in surgical specimen (diagnose pCR through MIB) were the main outcome measures.RESULTS: Pathological complete response in surgical specimen was diagnosed in 93 (56.7%) cases of the whole cohort. The NPV of the MIB diagnosis of pCR was 71.3% (95% CI: (63.3%; 79.3%)). The FNR was 49.3% (95% CI: (40.4%; 58.2%)). Existence of a clip marker tended to improve the NPV (odds ratio 1.98; 95% CI: (0.81; 4.85)). None of the mammographically guided VABs (n=16) was false-negative (FNR 0%, NPV 100%).CONCLUSIONS: Overall accuracy of MIB diagnosis of pCR was insufficient to suggest changing clinical practice. However, subgroup analyses (mammographically guided VABs) suggest a potential capacity of MIB techniques to precisely diagnose pCR after NACT. Representativity of MIB could be a crucial factor to be focused on in further analyses.

AB - BACKGROUND: Neoadjuvant chemotherapy (NACT) is widely used as an efficient breast cancer treatment. Ideally, a pathological complete response (pCR) can be achieved. Up to date, there is no reliable way of predicting a pCR. For the first time, we explore the ability of minimal invasive biopsy (MIB) techniques to diagnose pCR in patients with clinical complete response (cCR) to NACT in this study. This question is of high clinical relevance because a reliable pCR prediction could have direct implications for clinical practice.METHODS: In all, 164 patients were included in this review-board approved, multicenter pooled analysis of prospectively assembled data. Core-cut (CC)-MIB or vacuum-assisted (VAB)-MIB were performed after NACT and before surgery. Negative predictive values (NPV) and false-negative rates (FNR) to predict a pCR in surgical specimen (diagnose pCR through MIB) were the main outcome measures.RESULTS: Pathological complete response in surgical specimen was diagnosed in 93 (56.7%) cases of the whole cohort. The NPV of the MIB diagnosis of pCR was 71.3% (95% CI: (63.3%; 79.3%)). The FNR was 49.3% (95% CI: (40.4%; 58.2%)). Existence of a clip marker tended to improve the NPV (odds ratio 1.98; 95% CI: (0.81; 4.85)). None of the mammographically guided VABs (n=16) was false-negative (FNR 0%, NPV 100%).CONCLUSIONS: Overall accuracy of MIB diagnosis of pCR was insufficient to suggest changing clinical practice. However, subgroup analyses (mammographically guided VABs) suggest a potential capacity of MIB techniques to precisely diagnose pCR after NACT. Representativity of MIB could be a crucial factor to be focused on in further analyses.

KW - Adult

KW - Aged

KW - Breast

KW - Breast Neoplasms

KW - Chemotherapy, Adjuvant

KW - False Negative Reactions

KW - Female

KW - Humans

KW - Image-Guided Biopsy

KW - Middle Aged

KW - Neoadjuvant Therapy

KW - Predictive Value of Tests

KW - Retrospective Studies

KW - Treatment Outcome

KW - Journal Article

KW - Multicenter Study

U2 - 10.1038/bjc.2015.381

DO - 10.1038/bjc.2015.381

M3 - SCORING: Journal article

C2 - 26554654

VL - 113

SP - 1565

EP - 1570

JO - BRIT J CANCER

JF - BRIT J CANCER

SN - 0007-0920

IS - 11

ER -