The effect of neoadjuvant therapy on radiological, surgical, and pathological results in nonmetastatic breast cancer: A retrospective observational study

The aim of the study was to evaluate the concordance between radiological imaging modalities and pathological findings and to test whether neoadjuvant therapy (NAT) is included in surgical planning, especially in the appropriateness of breast-conserving surgery (BCS). We conducted a retrospective observational study in 280 patients diagnosed with nonmetastatic breast cancer, including [NAT(+): 75 and NAT(-): 205]. Radiological examinations included ultrasonography, mammography, and magnetic resonance imaging before and after NAT. We compared the surgical outcomes, with pathological findings between these groups. In our statistical analyses, we examined the agreement of radiological, surgical, and pathological findings using Pearson chi-square test, Fisher exact test, and the Kappa coefficient. In addition, the data were analyzed using the Python artificial intelligence program and the results were presented. In the study, it was observed that compliance was higher in patients who received NAT compared with those who did not, BCS compliance increased significantly, patients who were not suitable for BCS after NAT became suitable, and there was inconsistency between radiological and pathological findings. Neoadjuvant therapy improves radiological compliance and increases the feasibility of BCS in patients with nonmetastatic breast cancer by effectively reducing tumor size and facilitating more precise surgical planning. Future studies should focus on integrating advanced imaging techniques and molecular profiling to improve treatment strategies and patient outcomes.