Do Decreased Breast Microcalcifications After Neoadjuvant Chemotherapy Predict Pathologic Complete Response?

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Accurate assessment of clinical response to neoadjuvant chemotherapy for breast cancer is crucial for treatment decisions.
• Mammography's correlation with pathologic response is lower compared to MRI or ultrasonography.
• Microcalcifications' role in mammographic assessment after neoadjuvant chemotherapy requires further clarification.

Purpose of the Study:

• To identify characteristics of breast cancer patients with decreased microcalcifications after neoadjuvant chemotherapy.
• To enhance the accuracy of mammographic assessment in evaluating treatment response.

Main Methods:

• Retrospective review of 70 breast cancer patients treated with neoadjuvant chemotherapy.
• Examination of microcalcification characteristics before and after treatment.
• Evaluation of stromal tumor-infiltrating lymphocytes and pathologic complete response.

Main Results:

• Breast cancer with microcalcifications showed higher human epidermal growth factor receptor 2 positivity (48% vs. 22%).
• Only 6 of 33 patients with pre-treatment microcalcifications experienced a decrease post-chemotherapy.
• Decreased microcalcifications were associated with high stromal tumor-infiltrating lymphocytes, segmental, and pleomorphic/linear calcifications.

Conclusions:

• Neoadjuvant chemotherapy can reduce malignant microcalcifications, particularly segmental and pleomorphic/linear types.
• Further research into microcalcification formation and disappearance is needed.
• Establishing consensus on the utility of mammographic microcalcifications for treatment response evaluation is important.