Menes Tehillah S, Golan Orit, Vainer Gilead, Lerman Hedva, Schneebaum Schlomo, Klausner Joseph, Even-Sapir Einat
Department of Surgery, Tel Aviv Sourasky Medical Center, and Sackler School of Medicine, Tel Aviv, Israel.
Department of Radiology, Tel Aviv Sourasky Medical Center, and Sackler School of Medicine, Tel Aviv, Israel.
Clin Breast Cancer. 2016 Oct;16(5):389-395. doi: 10.1016/j.clbc.2016.05.015. Epub 2016 May 14.
Assessment of residual disease after neoadjuvant therapy for breast cancer is an ongoing challenge of breast imaging. This study evaluates the accuracy of a novel dedicated system for molecular breast imaging (MBI) composed of the new generation of cadmium zinc telluride detectors in assessing residual disease after neoadjuvant therapy in patients with breast cancer.
Clinical data, imaging, surgical, and pathological findings of 51 women with breast cancer undergoing neoadjuvant therapy were recorded. MBI findings were correlated with surgical pathology results. Accuracy of MBI in predicting complete pathological response and size of residual disease was assessed according to molecular subtypes.
The size of the largest focus of uptake on MBI correlated with the largest dimension measured on pathology (r = 0.55; P < .001). This correlation was stronger for triple negative and HER2/neu positive subtypes (r = 0.92 and 0.62, respectively). Sixteen patients (31%) had complete pathological response. The sensitivity and specificity of MBI for detecting residual disease were 83% (95% confidence interval [CI], 66-93) and 69% (95% CI, 42-88), respectively. For triple negative or HER2/neu positive disease the sensitivity and specificity were 88% (95% CI, 62-98) and 75% (95% CI, 43-93), respectively.
The accuracy of MBI in assessing residual disease after neoadjuvant treatment might be related to the molecular subtype. Accuracy is highest in the triple negative and HER2/neu positive subtypes.
评估乳腺癌新辅助治疗后的残留病灶是乳腺成像领域持续面临的挑战。本研究评估了一种新型专用分子乳腺成像（MBI）系统的准确性，该系统由新一代碲化镉锌探测器组成，用于评估乳腺癌患者新辅助治疗后的残留病灶。
记录了51例接受新辅助治疗的乳腺癌女性的临床数据、影像学、手术及病理结果。将MBI检查结果与手术病理结果进行关联。根据分子亚型评估MBI预测完全病理缓解及残留病灶大小的准确性。
MBI上最大摄取灶的大小与病理测量的最大径相关（r = 0.55；P <.001）。这种相关性在三阴性和HER2/neu阳性亚型中更强（分别为r = 0.92和0.62）。16例患者（31%）达到完全病理缓解。MBI检测残留病灶的敏感性和特异性分别为83%（95%置信区间[CI]，66 - 93）和69%（95% CI，42 - 88）。对于三阴性或HER2/neu阳性疾病，敏感性和特异性分别为88%（95% CI，62 - 98）和75%（95% CI，43 - 93）。
MBI评估新辅助治疗后残留病灶的准确性可能与分子亚型有关。在三阴性和HER2/neu阳性亚型中准确性最高。
