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Assessment of Residual Disease With Molecular Breast Imaging in Patients Undergoing Neoadjuvant Therapy: Association
Tehillah S Menes1, Orit Golan2, Gilead Vainer3
1Department of Surgery, Tel Aviv Sourasky Medical Center, and Sackler School of Medicine, Tel Aviv, Israel.
Background:
Assessment of residual disease after neoadjuvant therapy for breast cancer is an ongoing challenge of breast imaging. This study evaluates the accuracy of a novel dedicated system for molecular breast imaging (MBI) composed of the new generation of cadmium zinc telluride detectors in assessing residual disease after neoadjuvant therapy in patients with breast cancer.
Patients And Methods:
Clinical data, imaging, surgical, and pathological findings of 51 women with breast cancer undergoing neoadjuvant therapy were recorded. MBI findings were correlated with surgical pathology results. Accuracy of MBI in predicting complete pathological response and size of residual disease was assessed according to molecular subtypes.
Results:
The size of the largest focus of uptake on MBI correlated with the largest dimension measured on pathology (r = 0.55; P < .001). This correlation was stronger for triple negative and HER2/neu positive subtypes (r = 0.92 and 0.62, respectively). Sixteen patients (31%) had complete pathological response. The sensitivity and specificity of MBI for detecting residual disease were 83% (95% confidence interval [CI], 66-93) and 69% (95% CI, 42-88), respectively. For triple negative or HER2/neu positive disease the sensitivity and specificity were 88% (95% CI, 62-98) and 75% (95% CI, 43-93), respectively.
Conclusion:
The accuracy of MBI in assessing residual disease after neoadjuvant treatment might be related to the molecular subtype. Accuracy is highest in the triple negative and HER2/neu positive subtypes.
Insights
Molecular breast imaging (MBI) shows promise in assessing residual breast cancer after neoadjuvant therapy. Its accuracy is highest for triple-negative and HER2/neu positive subtypes, aiding treatment response evaluation.
Area of Science:
- Oncology
- Medical Imaging
- Radiology
Background:
- Assessing residual disease after neoadjuvant therapy for breast cancer presents a challenge in breast imaging.
- This study focuses on a novel molecular breast imaging (MBI) system with advanced cadmium zinc telluride detectors.
Purpose of the Study:
- To evaluate the accuracy of a new dedicated MBI system in assessing residual disease post-neoadjuvant therapy for breast cancer patients.
- To determine MBI's effectiveness in predicting complete pathological response and residual disease size across different molecular subtypes.
Main Methods:
- Clinical, imaging, surgical, and pathological data from 51 breast cancer patients were collected.
- MBI findings were correlated with surgical pathology results.
- Accuracy was assessed based on molecular subtypes: triple-negative, HER2/neu positive, and others.
Main Results:
- MBI uptake size correlated with pathology measurements (r=0.55, P<.001), with stronger correlation in triple-negative and HER2/neu positive subtypes (r=0.92, 0.62).
- MBI sensitivity and specificity for residual disease were 83% and 69%, respectively.
- For triple-negative or HER2/neu positive disease, sensitivity and specificity improved to 88% and 75%.
Conclusions:
- MBI accuracy in assessing residual breast cancer after neoadjuvant treatment varies by molecular subtype.
- The MBI system demonstrates highest accuracy for triple-negative and HER2/neu positive breast cancer subtypes.
