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Accuracy of unidimensional and volumetric ultrasound measurements in predicting good pathological response to neoadjuvant chemotherapy in breast cancer patients
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Gounaris, I., Provenzano, E., Vallier, A. L., Hiller, Louise, Iddawela, M., Hilborne, S., Taylor, K. (Kathryn), Britton, Peter, Earl, Helena M. and Sinnatamby, R. (2011) Accuracy of unidimensional and volumetric ultrasound measurements in predicting good pathological response to neoadjuvant chemotherapy in breast cancer patients. Breast Cancer Research and Treatment, Volume 127 (Number 2). pp. 459-469. doi:10.1007/s10549-011-1454-x ISSN 0167-6806.
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Official URL: http://dx.doi.org/10.1007/s10549-011-1454-x
Abstract
Pathological complete response (pCR) is an important predictor of long-term survival in patients with breast cancer receiving neoadjuvant chemotherapy (NAC). At present, the accuracy of traditional radiological assessments during treatment in predicting pCR is poor. Unidimensional and 3D volumetric ultrasound measurements prior to, after 4 cycles (mid-treatment), and at the end of 8 cycles (end-treatment) of chemotherapy were available from a subset of 55 patients enrolled in Neo-tAnGo, a National Cancer Research Network (NCRN) UK neoadjuvant chemotherapy breast cancer trial. Proportional changes in longest diameter (LD) and volume as well as absolute residual size thresholds were examined for their ability to predict pCR or pCR plus minimal residual disease (pCR/MRD). Sensitivity, specificity, positive (PPV) and negative predictive values (NPV) and likelihood ratios (LRs) were calculated. Receiver-operator characteristic (ROC) curves and logistic regression models were also constructed. At mid-treatment, neither complete radiological response, nor proportional LD or volume changes were found predictive of final pCR. A small residual tumour volume (a parts per thousand currency sign1 cm(3) vs. > 1 cm(3)) at mid-treatment, however, was associated with pCR/MRD (P = 0.014). Sensitivity, specificity, PPV, NPV, LR+ and LR- values were 61%, 77%, 61%, 77%, 2.62 and 0.51, respectively. The area under the ROC curve was 0.689 (P = 0.03). Volume a parts per thousand currency sign1 cm(3) at mid-treatment was found significant in a logistic regression (OR: 0.194, P = 0.011). At end-treatment, no ultrasound measurements were found predictive of pCR or pCR/MRD. In conclusion, proportional tumour size changes (the basis of the RECIST criteria) were not found predictive of good pathological response, although residual volume a parts per thousand currency sign1 cm(3) at mid-treatment was found to be predictive of pCR/MRD. However, multiple volume and LD thresholds were examined and uncorrected P values presented, increasing the possibility of type I errors. Replication in an independent dataset is required.
Item Type: | Journal Article | ||||
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Subjects: | R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer) | ||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Cancer -- Adjuvant treatment -- Evaluation, Preoperative care, Breast -- Cancer -- Chemotherapy, Breast -- Cancer -- Patients, Breast -- Cancer -- Pathophysiology | ||||
Journal or Publication Title: | Breast Cancer Research and Treatment | ||||
Publisher: | Springer | ||||
ISSN: | 0167-6806 | ||||
Official Date: | June 2011 | ||||
Dates: |
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Volume: | Volume 127 | ||||
Number: | Number 2 | ||||
Page Range: | pp. 459-469 | ||||
DOI: | 10.1007/s10549-011-1454-x | ||||
Status: | Peer Reviewed | ||||
Publication Status: | Published | ||||
Access rights to Published version: | Restricted or Subscription Access | ||||
Funder: | National Institute for Health Research (Great Britain) (NIHR), Cambridge Biomedical Research Centre (BMRC) |
Data sourced from Thomson Reuters' Web of Knowledge
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