Correlation of Histopathological and Radiological Response Patterns and Their Prognostic Implications in Breast...

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Neoadjuvant chemotherapy (NAC) response in breast cancer (BC) is crucial for treatment planning and survival.
• Response patterns include concentric shrinkage (CS), non-concentric shrinkage (non-CS), and complete response.
• Radiological and histopathological assessments are used to evaluate tumor response post-NAC.

Purpose of the Study:

• To evaluate the correlation between histopathological and radiological response patterns in BC patients after NAC.
• To assess the impact of these response patterns on overall survival (OS) and disease-free survival (DFS).

Main Methods:

• Retrospective analysis of 168 BC patients treated with NAC (2018-2022).
• Tumor response assessed via MRI (radiological) and post-surgical histopathology.
• Concordance analyzed using kappa statistic; survival using Kaplan-Meier methods.

Main Results:

• Moderate agreement (κ: 0.439) between radiological and histopathological assessments.
• Radiological evaluation accurately identified 64% of CS, 50% of non-CS, and 74% of pCR cases.
• Tumor molecular subtypes significantly correlated with response patterns; pCR rates higher in TN, HER2-enriched, and Luminal B-HER2(+) subtypes.
• No significant correlation found between response patterns and OS or DFS, though pCR trended towards better outcomes.

Conclusions:

• Moderate concordance exists between radiological and histopathological response patterns post-NAC, but discrepancies highlight limitations of imaging alone.
• Observed response patterns did not significantly correlate with prognosis.
• Achieving pathological complete response (pCR) is associated with improved survival, but response patterns alone are insufficient for survival prediction.