The use of breast ultrasound for prediction of pathologic complete response in different subtypes of early breast cancer within the WSG-ADAPT subtrials
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The use of breast ultrasound for prediction of pathologic complete response in different subtypes of early breast cancer within the WSG-ADAPT subtrials. / Graeser, Monika; Harbeck, Nadia; Gluz, Oleg; Würstlein, Rachel; Zu Eulenburg, Christine; Schumacher, Claudia; Grischke, Eva-Maria; Forstbauer, Helmut; Dimpfl, Moritz; Braun, Michael; Christgen, Matthias; Kreipe, Hans Heinrich; Potenberg, Jochem; von Schumann, Raquel; Aktas, Bahriye; Kolberg-Liedtke, Cornelia; Kümmel, Sherko; Nitz, Ulrike.
In: BREAST, Vol. 59, 10.2021, p. 58-66.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The use of breast ultrasound for prediction of pathologic complete response in different subtypes of early breast cancer within the WSG-ADAPT subtrials
AU - Graeser, Monika
AU - Harbeck, Nadia
AU - Gluz, Oleg
AU - Würstlein, Rachel
AU - Zu Eulenburg, Christine
AU - Schumacher, Claudia
AU - Grischke, Eva-Maria
AU - Forstbauer, Helmut
AU - Dimpfl, Moritz
AU - Braun, Michael
AU - Christgen, Matthias
AU - Kreipe, Hans Heinrich
AU - Potenberg, Jochem
AU - von Schumann, Raquel
AU - Aktas, Bahriye
AU - Kolberg-Liedtke, Cornelia
AU - Kümmel, Sherko
AU - Nitz, Ulrike
N1 - Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.
PY - 2021/10
Y1 - 2021/10
N2 - OBJECTIVE: We assessed the value of breast ultrasound (US) performed at week 3 and 6 and at the end (EOT) of neoadjuvant therapy (NAT) for prediction of pathologic complete response (pCR, ypT0/is ypN0) in patients with HR+/HER2+, HR-/HER2-or HR-/HER2+ early breast cancer enrolled in the WSG-ADAPT subtrials.METHODS: US was performed at week 3 and 6 of NAT and at EOT in 401, 517, and 553 patients, respectively. Tumors with complete or partial response by US (RECIST 1.1) were classified as responders and those with stable or progressive disease as non-responders.RESULTS: pCR rate was higher in US responders than in non-responders. US tended to yield the highest positive predictive value in HR-/HER2+ (69%) and HR-/HER2-tumors (65%) at week 3, and the highest negative predictive value in HR+/HER2+ tumors at week 6 and at EOT (88.9% and 86.9%, respectively) and in HR-/HER2-tumors at EOT (87.9%). Multivariable analysis of patients with US at week 3 and 6 identified tumor subtype (HR-/HER2+ vs HR+/HER2+; odds ratio (OR) 2.77, 95%CI 1.45-5.29, and OR 4.17, 95%CI 2.26-7.68, respectively) and each 10% change in lesion dimension on US from baseline (OR 1.15, 95%CI 1.08-1.24, and OR 1.25, 95%CI 1.16-1.35, respectively) as parameters associated with pCR.CONCLUSIONS: Our data support the use of week 3 and EOT US for prediction of pCR in response-guided NAT and in planning of breast-conserving surgery. Change in tumor diameter on US as a continuous variable could be a valuable alternative to categorical RECIST 1.1 criteria.
AB - OBJECTIVE: We assessed the value of breast ultrasound (US) performed at week 3 and 6 and at the end (EOT) of neoadjuvant therapy (NAT) for prediction of pathologic complete response (pCR, ypT0/is ypN0) in patients with HR+/HER2+, HR-/HER2-or HR-/HER2+ early breast cancer enrolled in the WSG-ADAPT subtrials.METHODS: US was performed at week 3 and 6 of NAT and at EOT in 401, 517, and 553 patients, respectively. Tumors with complete or partial response by US (RECIST 1.1) were classified as responders and those with stable or progressive disease as non-responders.RESULTS: pCR rate was higher in US responders than in non-responders. US tended to yield the highest positive predictive value in HR-/HER2+ (69%) and HR-/HER2-tumors (65%) at week 3, and the highest negative predictive value in HR+/HER2+ tumors at week 6 and at EOT (88.9% and 86.9%, respectively) and in HR-/HER2-tumors at EOT (87.9%). Multivariable analysis of patients with US at week 3 and 6 identified tumor subtype (HR-/HER2+ vs HR+/HER2+; odds ratio (OR) 2.77, 95%CI 1.45-5.29, and OR 4.17, 95%CI 2.26-7.68, respectively) and each 10% change in lesion dimension on US from baseline (OR 1.15, 95%CI 1.08-1.24, and OR 1.25, 95%CI 1.16-1.35, respectively) as parameters associated with pCR.CONCLUSIONS: Our data support the use of week 3 and EOT US for prediction of pCR in response-guided NAT and in planning of breast-conserving surgery. Change in tumor diameter on US as a continuous variable could be a valuable alternative to categorical RECIST 1.1 criteria.
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Breast Neoplasms/drug therapy
KW - Female
KW - Humans
KW - Neoadjuvant Therapy
KW - Receptor, ErbB-2
KW - Ultrasonography, Mammary
U2 - 10.1016/j.breast.2021.06.001
DO - 10.1016/j.breast.2021.06.001
M3 - SCORING: Journal article
C2 - 34166854
VL - 59
SP - 58
EP - 66
JO - BREAST
JF - BREAST
SN - 0960-9776
ER -