Abstract
Abstract Introduction. In patients with advanced breast cancer, neoadjuvant chemo-therapy is performed to increase breast conserving surgery. Although MRI is known to be accurate in predicting residual cancer after treatment, if calcification remains, the issue of whether to perform surgery based on the residual tumor prediction range in mammography and MRI has not yet been solved. The objective of this study was to estimate the accuracy of residual mammographic (MMG) microcalcification and enhancing lesion in magnetic resonance imaging (MRI) in predicting residual tumor after neoadjuvant systemic treatment (NST). Method. This is a single-center, retrospective study. We included patients with breast cancer who underwent NST and have microcalcifications in the post NST mammogram and had the surgery from January 2, 2013 to December 30, 2014. All the patients had post NST imaging exams of MMG and MRI. Final pathologic tumor size with histopathology and biomarker status was obtained after surgery. Analysis of correlation between image findings and pathology was evaluated. Result. Of 151 patients that were included in this study, 125 patients (82.8%) had residual invasive tumor and 26 patients (17.2%) had pathologic complete response. In overall, MRI correlated better than MMG in predicting tumor size (intraclass correlation coefficient [ICC] = 0.769 vs 0.651), but for HR+/HER2- subtype, MMG had higher correlation than MRI (ICC = 0.747 vs 0.575). Specially in HR- subtype, MRI had strong correlation with pathology (ICC for HR-/HER2+ = 0.939 and TN = 0.75), while MMG tend to overestimate the tumor size (ICC for HR-/HER2+ = 0.543 and TN = 0.479). Discussion. Overall post-NST residual microcalcifications on MMG have lower correlation with residual tumor size than MRI. In other than HR+/HER2- subtype, the extent of calcifications on pre-OP evaluation may not be accurate in evaluating the residual extent of the tumor after NST. Citation Format: Um E. histopathologic correlation of residual tumor in breast with residual mammographic microcalcification and magnetic resonance imaging after neoadjuvant systemic treatment [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-12-09.
Published Version
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