Can a pathological complete response of breast cancer after neoadjuvant chemotherapy be diagnosed by minimal invasive biopsy?

Background This study aimed to explore the ability of a minimal invasive biopsy to diagnose a pathological complete response (pCR = ypT0) in the breast. Methods Ultrasound-guided, vacuum-assisted, minimal invasive biopsy (VAB) was performed in 50 patients after neoadjuvant chemotherapy and before br...

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Publicado en:European Journal of Cancer Vol. 69; pp. 142 - 151
Autores principales: Heil, Joerg, Schaefgen, Benedikt, Sinn, Peter, Richter, Hannah, Harcos, Aba, Gomez, Christina, Stieber, Anne, Hennigs, André, Rauch, Geraldine, Schuetz, Florian, Sohn, Christof, Schneeweiss, Andreas, Golatta, Michael
Formato: research Journal Article
Publicado: Pergamon Press - An Imprint of Elsevier Science Dec2016
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2016
      vid: 69
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      pub: Pergamon Press - An Imprint of Elsevier Science
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        119773017
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        119773017
        10.1016/j.ejca.2016.09.034
        119773017
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        atl: Can a pathological complete response of breast cancer after neoadjuvant chemotherapy be diagnosed by minimal invasive biopsy?
      aug:
        au:
          Heil, Joerg
          Schaefgen, Benedikt
          Sinn, Peter
          Richter, Hannah
          Harcos, Aba
          Gomez, Christina
          Stieber, Anne
          Hennigs, André
          Rauch, Geraldine
          Schuetz, Florian
          Sohn, Christof
          Schneeweiss, Andreas
          Golatta, Michael
        affil: University Breast Unit, Department of Gynecology, Im Neuenheimer Feld 440, 69120, Heidelberg, Germany
      sug:
        subj:
          Neoadjuvant Therapy
          Breast Neoplasms Drug Therapy
          Biopsy Methods
          Minimally Invasive Procedures
          Chemotherapy, Adjuvant
          False Negative Results
          Breast Neoplasms Surgery
          Human
          Predictive Value of Tests
          Prospective Studies
          Confidence Intervals
      ab: Background This study aimed to explore the ability of a minimal invasive biopsy to diagnose a pathological complete response (pCR = ypT0) in the breast. Methods Ultrasound-guided, vacuum-assisted, minimal invasive biopsy (VAB) was performed in 50 patients after neoadjuvant chemotherapy and before breast surgery. Negative predictive values (NPV) and false negative rates (FNR) to predict a pCR in surgical specimen were the main outcome measures. To assess the possible sampling error, the representativeness of the sample was evaluated by the biopsy performing physician (subjectively based on the visibility in ultrasound), by radiography of the biopsy specimen, and by the pathologist (based on histopathology). Results The cohort (n = 50) consisted of 15 (30%) triple negative breast cancers, 13 (26%) human epidermal growth factor receptor 2 (HER2) positive and 22 (44%) hormone receptor positive/HER2 negative cancers. ypT0 was diagnosed in 23 (46%) cases. In the overall cohort (n = 50), VAB yielded an NPV of 76.7% and an FNR of 25.9%. Given a representative VAB sample, according to the histopathological evaluation (n = 38), the NPV was 94.4% (95% CI 87.1–100.0) and the FNR 4.8% (95% CI 0.0–11.6). Non-representative VABs were mainly due to bad visibility of the target lesion in ultrasound. Conclusion A VAB can accurately diagnose a pCR, given a histopathologically representative sample.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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