Mello Juliana M, Sarvacinski Flavia, Schaefer Flavia C, Ercolani Daniel S, Lobato Nathalia R, Martins Yasmine C, Zwetsch Guilherme, Bittelbrunn Fernando P, Ferreira Charles F, Damin Andrea P
Radiology, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, BRA.
Medicine, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, BRA.
Cureus. 2022 Oct 5;14(10):e29960. doi: 10.7759/cureus.29960. eCollection 2022 Oct.
We aimed to evaluate volume reduction in digital mammography (DM) and ultrasound (US) for neoadjuvant chemotherapy (NAC) evaluation, with breast cancer-specific survival and pathological complete response (pCR) associations.
This is a retrospective observational cohort study analyzing recorded images in 122 selected subjects out of which 569 patients presented with advanced breast cancers. Spearman's correlation and generalized estimating equations (GEE) compared volume reduction on DM and US between pCR and non-pCR after NAC with post-surgical anatomopathology. Cox regression and Kaplan-Meier curves analyzed associations between cancer-specific survival, pCR, and volume reductions.
A total of 34.4% (N=42) obtained pCR and 65.6% (N=80) did not. Minimum percentage indexes needed to correlate with pCR over time were, at least, 28.9% for DM (p=0.006) and 10.36% for US (p=0.046), with high specificity (US=98%, DM=93%) but low sensitivity (US=7%, DM=18%). Positive predictive values were 82% (DM) and 86% (US) and negative predictive values were 37% (DM) and 36% (US). Cox regression and Kaplan-Meier curves demonstrated associations of breast cancer-specific survival with pCR (Cox regression coefficient {B}=0.209, CI 95%=0.048-0.914, p=0.038).
At least 28.9% of volume reduction on DM and 10.36% of volume reduction on US are correlated with pCR. Furthermore, pCR was associated with breast cancer-specific survival after NAC in volumetric morphological imaging analysis.
我们旨在评估数字乳腺摄影（DM）和超声（US）在新辅助化疗（NAC）评估中的体积缩小情况，以及与乳腺癌特异性生存和病理完全缓解（pCR）的相关性。
这是一项回顾性观察队列研究，分析了122名选定受试者的记录图像，其中569例患者患有晚期乳腺癌。采用Spearman相关性分析和广义估计方程（GEE），比较NAC后手术病理检查中pCR组和非pCR组在DM和US上的体积缩小情况。采用Cox回归和Kaplan-Meier曲线分析癌症特异性生存、pCR和体积缩小之间的相关性。
共有34.4%（N = 42）的患者获得了pCR，65.6%（N = 80）的患者未获得。随着时间的推移，与pCR相关的最小百分比指标分别为，DM至少为28.9%（p = 0.006），US至少为10.36%（p = 0.046），特异性较高（US = 98%，DM = 93%）但敏感性较低（US = 7%，DM = 18%）。阳性预测值分别为82%（DM）和86%（US），阴性预测值分别为37%（DM）和36%（US）。Cox回归和Kaplan-Meier曲线显示乳腺癌特异性生存与pCR相关（Cox回归系数{B}=0.209，95%CI = 0.048 - 0.914，p = 0.038）。
DM上至少28.9%的体积缩小和US上至少10.36%的体积缩小与pCR相关。此外，在体积形态学成像分析中，pCR与NAC后的乳腺癌特异性生存相关。
