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Axillary ultrasound for predicting response to neoadjuvant treatment in breast cancer patients [Elektronski vir] : a single institution experiencePišlar, Nina ...In node-positive breast cancer patients at diagnosis (cN+) that render node-negative after neoadjuvant systemic treatment (NAST), axillary lymph node dissection (ALND) can be avoided in selected ... cases. Axillary ultrasound (AUS) is most often used for re-staging after NAST. We aimed to determine sensitivity, specifcity, positive predictive value (PPV), and negative predictive value (NPV) of AUS after NAST for predicting nodal response at the Institute of Oncology, Ljubljana. Methods Biopsy-confrmed cN+patients consecutively diagnosed at our institution between 2008 and 2021, who received NAST, followed by surgery were identifed retrospectively. Only patients that underwent AUS after NAST were included. AUS results were compared to defnite nodal histopathology results. We calculated sensitivity, specifcity, PPV and NPV of AUS. We also calculated the proportion of patients with false-positive AUS that results in surgical overtreatment (unnecessary ALND). Results We identifed 437 cN+patients. In 244 (55.8%) AUS after NAST was performed. Among those, 42/244 (17.2%) were triple negative (TN), 78/244 (32.0%) Her-2 positive (Her-2+), and 124/244 (50,8%) luminal Her-2 negative cancers. AUS was negative in 179/244 (73.4%), suspicious/positive in 65/244 (26.6%) (11/42 (26.2%) TN, 19/78 (24.4%) Her-2+, and 35/124 (28.2%) luminal Her-2 negative cancers). On defnite histopathology, nodal complete response (pCR) was observed in 89/244 (36.5%) (19/42 (45.2%) TN, 55/78 (70.5%) Her-2+, and 15/124 (12.1%) luminal Her-2 negative cancers). Among patients with suspicious/positive AUS, pCR was observed in 20/65 (30.8%) (6/11 (54.5%) TN, 13/19 (68.4%) Her-2+and 1/35 (2.9%) luminal Her-2 negative cancers). Sensitivity was 29.0%, specifcity 77,5%, PPV 69.2%, NPV 38.5%. Specifcity and PPV in TN was 68.4% and 45.4%, in Her-2+76.4% and 31.6%, in luminal Her-2 negative 93,3% and 97,1%, respectively. Conclusion In approximately half of the patients, AUS falsely predicts nodal response after NAST and may lead to overtreatment in 30% of the cases (ALND). However, AUS has to be interpreted in context with tumor subtype. In luminal Her-2 negative cancers, it has a high PPV and is therefore usefuSource: World journal of surgical oncology [Elektronski vir]. - ISSN 1477-7819 (Vol. 21, no. 1, 2023, 292-1-292-6)Type of material - e-article ; adult, seriousPublish date - 2023Language - englishCOBISS.SI-ID - 167104259
Author | Pišlar, Nina ... |
Title | Axillary ultrasound for predicting response to neoadjuvant treatment in breast cancer patients [Elektronski vir] : a single institution experience |
Publication date | 2023-09-16 |
COBISS.SI-ID | 167104259 |
Publication version in repository | Publisher's version |
Publication licence | Creative Commons Attribution 4.0 International |
Embargo | Unidentified |
Project(s) from which the publication was funded
Title | Acronym | Project ID | Funder |
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Družine s povišano ali visoko ogroženostjo za raka: svetovanje, odkrivanje mutacij in preprečevanje raka | P3-0352-2018 |
Javna agencija za znanstvenoraziskovalno in inovacijsko dejavnost Republike Slovenije |
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Cost type | Total cost | Payments |
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APC – Article Processing Charge | 2982.90 € |
2982.90 € : Onkološki inštitut Ljubljana |
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Database name | Field | Year |
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Links to authors' personal bibliographies | Links to information on researchers in the SICRIS system |
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Pišlar, Nina | |
Gašljević, Gorana | 36115 |
Marolt-Mušič, Maja | 24570 |
Borštnar, Simona, 1967- | 16303 |
Žgajnar, Janez, 1963- | 12767 |
Perhavec, Andraž | 26530 |
Source: Personal bibliographies
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