Department of Obstetrics and Gynecology, Division of General Gynecology and Gynecologic Oncology, Medical University of Vienna, Austria.
Department of Obstetrics and Gynecology, Division of Gynecological Endocrinology and Reproductive medicine, Medical University of Innsbruck, Austria.
Clin Breast Cancer. 2022 Feb;22(2):149-160. doi: 10.1016/j.clbc.2021.05.017. Epub 2021 Jun 10.
Neoadjuvant chemotherapy (NAC) in combination with anti-HER2 treatment is standard of care in patients with early HER2 positive breast cancer. Preoperative radiological evaluation is mandatory for defining the extent of surgery. In this study, we evaluated the correlation between preoperative radiological and postoperative pathological tumor size in early HER2 positive patients after neoadjuvant chemotherapy in combination with trastuzumab and pertuzumab. In a patient population with HER2 positive breast cancer, who received neoadjuvant chemotherapy and anti-HER2 treatment, the correlation between preoperative radiological and postoperative pathological tumor size was performed. Concordance of radiological and pathological tumor size was found in 55.7%, leading to more extensive breast surgery as required in 7 cases and to the underestimation of 6 neoplastic lesions before surgery, respectively.
Seventy early HER2 positive breast cancer patients were included and retrospectively analysed. All preoperative radiological assessments as well as the tumor board decision on surgical extent and pathological evaluation were completed at the Medical University of Vienna. Preoperative radiological assessment of tumor size and lymph node status were compared with final histopathological findings. The correlation between different radiological modalities regarding tumor size was investigated.
Concordance of radiological and pathological tumor size was found in 55.7 % (50% by sonography and 66.7% by MRI, respectively) of patients with a nonsignificant correlation of r = 0.31 (P = .08). Of the 39 patients with pathologic complete remission (pCR), 16 were also classified as radiological complete response (rCR) while 23 of those showed a radiological stable disease or partial response. In 6 patients, radiological assessment showed a CR but invasive cancer with a tumor size range from 7 to 36 mm was found in histopathological examination. Neither menopausal status (P= .69) nor BMI (P = .60) and age (P = .50) had an impact on the correlation between radiological and histopathological tumor size. Regarding lymph node status, a statistically significant association and clinically relevant correlation between radiological and histopathological evaluation was found (r = 0.66, P < .001).
Concordance between radiology and histopathology was low regarding tumor size after NAC in combination with trastuzumab and pertuzumab, but significant regarding lymph node status.
新辅助化疗（NAC）联合抗 HER2 治疗是早期 HER2 阳性乳腺癌患者的标准治疗方法。术前影像学评估是确定手术范围的必要条件。在这项研究中，我们评估了在接受曲妥珠单抗和帕妥珠单抗联合新辅助化疗的早期 HER2 阳性患者中，术前影像学和术后病理肿瘤大小之间的相关性。在接受新辅助化疗和抗 HER2 治疗的 HER2 阳性乳腺癌患者中，对术前影像学和术后病理肿瘤大小进行了相关性分析。研究发现，术前影像学和术后病理肿瘤大小的一致性为 55.7%，分别导致 7 例需要更广泛的乳房手术和术前低估 6 个肿瘤病变。
共纳入 70 例早期 HER2 阳性乳腺癌患者，进行回顾性分析。所有术前影像学评估以及维也纳医科大学的肿瘤委员会对手术范围和病理评估的决定均已完成。术前影像学评估肿瘤大小和淋巴结状态与最终组织病理学发现进行比较。研究了不同影像学方法在肿瘤大小方面的相关性。
在 55.7%（超声检查为 50%，MRI 检查为 66.7%）的患者中，术前影像学和术后病理肿瘤大小具有一致性，两者之间的相关性无统计学意义（r=0.31，P=0.08）。在 39 例病理完全缓解（pCR）患者中，16 例被归类为影像学完全缓解（rCR），而 23 例表现为影像学稳定疾病或部分缓解。在 6 例患者中，影像学评估显示为 CR，但在组织病理学检查中发现浸润性癌，肿瘤大小范围为 7 至 36mm。绝经状态（P=0.69）、BMI（P=0.60）和年龄（P=0.50）均未对影像学和组织病理学肿瘤大小之间的相关性产生影响。在淋巴结状态方面，影像学和组织病理学评估之间存在统计学显著关联和临床相关相关性（r=0.66，P<0.001）。
在曲妥珠单抗和帕妥珠单抗联合新辅助化疗后，影像学和组织病理学之间在肿瘤大小方面的一致性较低，但在淋巴结状态方面具有显著相关性。
