Aims and objectives
Breast cancer represents a heterogeneous disease that comprises different molecular subtypes characterized by diverse histological characteristics,
and prognostic implications.
In patients with locally advanced breast tumors neoadjuvant chemotherapy (NAC) has become a standard therapeutic approach.
Pathological complete response (pCR) to NAC has been shown to be a surrogate endpoint of long-term event-free and overall survival in breast cancer patients.
NAC may be limited by a number of toxic side effects; therefore,
a staging procedure capable of predicting response to NAC could...
Methods and materials
Patient selection: Patients with a diagnosis of locally advanced breast cancer,
treated at our Center between January 2010 and January 2018,
were retrospectively collected.
We included in our study population patients with histological diagnosis of primary breast cancer,
who performed 18F-FDG PET/CT for staging purposes before any treatment and were treated with NAC as primary treatment followed by surgery.77 patients were enrolled in the study; histological characteristics of the primary tumor (expression of hormone receptors,
tumor dimensions and grade,
Main analysis: In the first model (including clinical data and first-order imaging features),
and HER2 status satisfied the inclusion threshold for the univariable analysis.
Since the molecular subtype is defined based on the expression of selected receptors,
the HER2 status was removed from the model due to possible collinearity issues.Thus,
age and molecular subtype were includedin the first model with theactual AUC of0.71 (table 1).
For the second model (including clinical data,
first-,second- and higher-order imaging features),
Our study has some limitations.
Clinical data were not available for all patients due to the retrospective nature of the study.
The small sample size limited the statistical powerof the results.
patient selection and the methods used for data analysis were extremely rigorous.
Our findings suggest that radiomics PET-derived features couldbe associated with pCR to NAC.
Advanced image analysis should be further evaluated in a large population to better clarify and quantitate the potential predictive role of textural features in locally advanced breast cancer...
Van De Rijn M,
Molecular portraits of human breast tumours.
Von Minckwitz G,
Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes.
J Clin Oncol.
Relationship between tumor heterogeneity measured on FDG-PET/CT and pathological prognostic...