Primary breast cancer: mammographic changes after neoadjuvant chemotherapy, with pathologic correlation

Area of Science:

• Oncology
• Radiology
• Pathology

Background:

• Neoadjuvant chemotherapy is a standard treatment for operable breast carcinoma.
• Accurate assessment of treatment response is crucial for guiding further management.
• Mammography is frequently used to monitor treatment response.

Purpose of the Study:

• To correlate mammographic changes during neoadjuvant chemotherapy with the subsequent pathologic status in operable breast carcinoma.
• To evaluate the predictive value of mammographic response for treatment success.

Main Methods:

• 107 patients with operable breast carcinoma underwent mammography before and after neoadjuvant chemotherapy.
• Mammographic response was retrospectively graded as complete, mammographic, stable disease, or progressive disease.
• Pathologic status was assessed after surgery.

Main Results:

• In 95 assessable patients, 82% showed a mammographic response, while only 9% had a complete response.
• A decrease in mass size >2 cm was observed in 21% of patients post-treatment compared to 67% pre-treatment.
• No complete response was seen in cases with microcalcifications.
• Of 8 patients with complete mammographic response, 5 had residual tumor, and 3 had an invasive component.

Conclusions:

• Mammography indicates tumor response to neoadjuvant chemotherapy in most breast cancer patients.
• Mammographic findings alone are insufficient to predict the pathologic outcome.
• Further investigation is needed to improve the prediction of pathologic response based on imaging.