Do Decreased Breast Microcalcifications After Neoadjuvant Chemotherapy Predict Pathologic Complete Response? |
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| Institution: | 1. Department of Clinical Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran;2. Safety Promotion and Injury Prevention Research Center, Shahid Beheshti University of Medical Sciences, Tehran, IR, Iran;1. Division of Breast Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Linko and Taipei, Taiwan;2. Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linko, Taiwan;3. Department of Radio-oncology, Chang Gung Memorial Hospital, Linko, Taiwan;4. Chang Gung Medical Foundation, Taoyuan, Taiwan;5. College of Medicine, Chang Gung University, Taoyuan, Taiwan;1. Clinica Oncologica, Università Politecnica delle Marche, AOU Ospedali Riuniti, Ancona, Italy;2. Oncology Unit II, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy;3. Anatomia Patologica e Citologia, AO Ospedali Riuniti Marche Nord, Pesaro, Italy;1. Mail Box 4, Ninewells Medical School, University of Dundee, Dundee, DD1 9SY, United Kingdom;2. Breast Unit, Ninewells Hospital, Dundee, DD1 9SY, United Kingdom;3. Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, United States |
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| Abstract: | BackgroundClinical response evaluation by image examination after neoadjuvant chemotherapy for breast cancer is important for determining drug response and progression. Mammography is less correlated with pathologic response assessment than magnetic resonance imaging or ultrasonography. The present study clarified characteristics of breast cancer patients with decreased microcalcifications after neoadjuvant chemotherapy to increase the accuracy of mammographic assessment.Patients and MethodsConsecutive patients who received neoadjuvant chemotherapy for breast cancer at our hospital from January 2013 to June 2017 were retrospectively reviewed. Characteristics of cases of microcalcifications before neoadjuvant chemotherapy and those showing a reduction after were examined. Stromal tumor-infiltrating lymphocytes were evaluated in the biopsy. Pathologic complete response was also explored in patients exhibiting a decrease in microcalcifications by neoadjuvant chemotherapy.ResultsSeventy breast cancer cases were included; 37 had no malignant microcalcifications before neoadjuvant chemotherapy and 33 did. Breast cancer with microcalcifications was significantly more positive for human epidermal growth factor receptor 2 than those without microcalcifications (48% vs. 22%, P = .018). Only 6 of 33 patients with microcalcifications before neoadjuvant chemotherapy showed a decrease after treatment. These patients tended to have high stromal tumor-infiltrating lymphocytes (50% vs. 17%), segmental microcalcifications (66% vs. 33%), and pleomorphic/linear microcalcifications (83% vs. 37%).ConclusionThese results suggest that neoadjuvant chemotherapy is able to decrease malignant calcifications, particularly segmental and pleomorphic/linear microcalcifications. By clarifying the mechanisms of formation and disappearance of microcalcifications, a consensus can be reached on whether microcalcifications apparent by mammography are useful for evaluating response to neoadjuvant chemotherapy. |
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| Keywords: | Breast cancer Mammography Microcalcifications Neoadjuvant chemotherapy |
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