Performance of Contrast-Enhanced Mammography (CEM) for Monitoring Neoadjuvant Chemotherapy Response among Different Breast Cancer Subtypes
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. CEM Examination
2.2. Image Analysis
2.3. Pathologic Review
- Hormone receptor (HR)+/HER2−: ER and/or PR positivity (at least 1% of the cancer cells) and HER2 0/1+ at immunohistochemistry.
- HER2+ HR−: ER and PR negativity and HER2 3+ or 2+ along with HER2 gene amplification by fluorescence in situ hybridization on core biopsy.
- Triple-negative breast cancer (TNBC): ER and PR negativity and HER2 0 or 1+.
- PCR was defined as absence of invasive cells in surgical specimen (ypT0~Tis).
- Ki67 levels were classified as low if ≤20% and high if >20% [14].
2.4. Statistical Analysis
3. Results
- For HR+/HER2−, the sensitivity, specificity, PPV, and NPV were, respectively, 54.5% (95% CI; 26.5–80.6%), 80.9% (70.5–89%), 31.6% (95% CI; 53.9–87.7%), and 91.7% (82.9–96.9%);
- For HER2+, the sensitivity, specificity, PPV, and NPV for HER2+ were, respectively, 69.7% (95% CI; 53–83.5%), 65.4% (46.3–81.6%), 71.9% (95% CI; 55–85.4%), and 63% (44.2–79.4%);
- For TNBC, the sensitivity, specificity, PPV, and NPV were, respectively, 70% (95% CI; 48.3–86.8%), 66.7% (95% CI; 41.5–86.5%), 73.7% (95% CI; 51.7–89.7%), and 62.5% (95% CI; 38.2–83.0%).
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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General Population | rCR | p | ||||||
---|---|---|---|---|---|---|---|---|
No | Yes | |||||||
Median | Count | N% | Median | Count | N% | |||
Age (y.o.) | 55 | 58 | ||||||
Dimension (mm) | 27 | 25 | ||||||
rCR | no | 70 | 100% | |||||
yes | 104 | 100% | ||||||
pCR | no | 82 | 78.8% | 27 | 38.6% | 0.000 | ||
yes | 22 | 21.2% | 43 | 61.4% | ||||
HR+/HER2− | no | 44 | 42.3% | 51 | 72.9% | 0.000 | ||
yes | 61 | 57.7% | 19 | 27.1% | ||||
HER2+ | no | 77 | 74.0% | 38 | 54.3% | 0.007 | ||
yes | 27 | 26.0% | 32 | 45.7% | ||||
TNBC | no | 88 | 84.6% | 51 | 72.9% | 0.058 | ||
yes | 16 | 15.4% | 19 | 27.1% | ||||
Ki67 > 20% | no | 32 | 30.1% | 15 | 21.5% | 0.225 | ||
yes | 72 | 69.9% | 55 | 78.5% |
CR in Molecular Subgroups | HR+/HER2− | HER2+ | TNBC | |||||||
---|---|---|---|---|---|---|---|---|---|---|
pCR (%) | pCR (%) | pCR (%) | ||||||||
No | Yes | Tot | No | Yes | Tot | No | Yes | Tot | ||
rCR (%) | no | 55 (69.6%) | 5 (6.3%) | 61 (76.2%) | 17 (28.8%) | 10 (16.9%) | 27 (45.8%) | 10 (28.6%) | 6 (17.1%) | 16 (45.7%) |
yes | 13 (16.5%) | 6 (7.6%) | 19 (23.8%) | 9 (15.3%) | 23 (39.0%) | 32 (54.2%) | 5 (14.3%) | 14 (40.0%) | 19 (54.3%) | |
tot | 69 (86.2%) | 11 (13.8%) | 80 (100%) | 26 (44.1%) | 33 (55.9%) | 59 (100%) | 15 (42.9%) | 20 (57.1%) | 35 (100%) |
Population Groups | General | HR+/HER2− | HER2+ | TNBC | |
---|---|---|---|---|---|
PPV | % | 61.4 | 31.6 | 71.9 | 73.7 |
95% CI | 49.8–72.3 | 53.9–87.69 | 55.0–85.4 | 51.7–89.7 | |
NPV | % | 78.8 | 91.7 | 63.0 | 62.5 |
95% CI | 70.4–85.9 | 82.9–96.9 | 44.2–79.4 | 38.2–83.0 | |
Sens | % | 66.2 | 54.5 | 69.7 | 70.0 |
95% CI | 54.2–76.9 | 26.5–80.6 | 53.0–83.5 | 48.3–86.8 | |
Spec | % | 75.2 | 80.9 | 65.4 | 66.7 |
95% CI | 41.3–66.6 | 70.5–89.0 | 46.3–81.6 | 41.5–86.5 |
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Vidali, S.; Irmici, G.; Depretto, C.; Bellini, C.; Pugliese, F.; Incardona, L.A.; Di Naro, F.; De Benedetto, D.; Di Filippo, G.; Ferraro, F.; et al. Performance of Contrast-Enhanced Mammography (CEM) for Monitoring Neoadjuvant Chemotherapy Response among Different Breast Cancer Subtypes. Cancers 2024, 16, 2694. https://doi.org/10.3390/cancers16152694
Vidali S, Irmici G, Depretto C, Bellini C, Pugliese F, Incardona LA, Di Naro F, De Benedetto D, Di Filippo G, Ferraro F, et al. Performance of Contrast-Enhanced Mammography (CEM) for Monitoring Neoadjuvant Chemotherapy Response among Different Breast Cancer Subtypes. Cancers. 2024; 16(15):2694. https://doi.org/10.3390/cancers16152694
Chicago/Turabian StyleVidali, Sofia, Giovanni Irmici, Catherine Depretto, Chiara Bellini, Francesca Pugliese, Ludovica Anna Incardona, Federica Di Naro, Diego De Benedetto, Giacomo Di Filippo, Fabiola Ferraro, and et al. 2024. "Performance of Contrast-Enhanced Mammography (CEM) for Monitoring Neoadjuvant Chemotherapy Response among Different Breast Cancer Subtypes" Cancers 16, no. 15: 2694. https://doi.org/10.3390/cancers16152694