Imaging breast cancer response during neoadjuvant systemic therapy

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Neoadjuvant systemic therapy aims to enable breast-conserving surgery for large operable breast cancers.
• Accurate response assessment is crucial for surgical planning and prognosis.
• Delayed or inaccurate response assessment can lead to suboptimal treatment or delayed surgical intervention.

Purpose of the Study:

• To review the evidence for functional imaging techniques in assessing response to neoadjuvant systemic therapy for breast cancer.
• To compare the efficacy of functional imaging with conventional methods.

Main Methods:

• Review of existing literature on functional imaging techniques.
• Examination of scintimammography, functional computed tomography, dynamic magnetic resonance imaging, spectroscopy, and positron emission tomography.
• Focus on techniques measuring tumor vasculature, metabolism, and proliferation.

Main Results:

• Conventional methods (clinical exam, mammography, ultrasound) rely on tumor size changes, which are often delayed and poorly correlated with pathologic response.
• Functional imaging techniques offer potential for earlier and more sensitive detection of treatment response.
• These techniques assess biological changes (vasculature, metabolism, proliferation) rather than just size.

Conclusions:

• Functional imaging techniques show promise as superior tools for early response assessment in breast cancer neoadjuvant therapy.
• These methods may enable more personalized treatment strategies by identifying non-responders earlier.
• Improved response assessment can lead to tailored therapy and potentially better patient outcomes.