Risk scoring system for predicting breast conservation after neoadjuvant chemotherapy.

Area of Science:

• Oncology
• Surgical Oncology
• Radiology

Background:

• Neoadjuvant chemotherapy (NAC) is a standard treatment for breast cancer, aiming to shrink tumors before surgery.
• Breast-conserving surgery (BCS) is a preferred surgical option when feasible, preserving breast tissue.
• Predicting BCS eligibility after NAC is crucial for personalized treatment planning.

Purpose of the Study:

• To develop and validate a risk scoring system (RSS) for predicting the likelihood of achieving breast-conserving surgery (BCS) in breast cancer patients undergoing neoadjuvant chemotherapy (NAC).
• To identify key clinical and pathological factors associated with successful BCS after NAC.

Main Methods:

• Development of a risk scoring system (RSS) based on five variables: age < 50 years, primary tumor diameter < 60mm, absence of multifocality, absence of breast inflammation, and hormone receptor status.
• Scoring system ranged from 0 to 9.
• Internal and external validation of the RSS using receiver operating characteristic (ROC) curve analysis.

Main Results:

• The BCS rate in the training set was 32.6%.
• The developed RSS demonstrated good discrimination in the training set (Area Under Curve [AUC] = 0.78).
• Internal validation showed an AUC of 0.77, and external validation showed an AUC of 0.75, indicating consistent predictive performance.

Conclusions:

• The developed risk scoring system (RSS) is a validated tool for predicting breast-conserving surgery (BCS) feasibility in breast cancer patients receiving neoadjuvant chemotherapy (NAC).
• The RSS incorporates key predictors, offering a quantitative method to aid in surgical decision-making.
• This tool can help optimize treatment strategies and patient selection for BCS after NAC.