AI Article Synopsis
- Monitoring the effectiveness of neoadjuvant chemotherapy (NAC) in breast cancer may be enhanced through imaging, which varies based on tumor subtype (ER and HER2 status).
- A systematic review analyzed 106 studies, ultimately including 15 that focused on imaging's ability to predict pathologic complete response (pCR) during NAC, finding significant variability in how response and monitoring intervals were defined.
- Imaging performance metrics (sensitivity, specificity, and so on) differed greatly by subtype, indicating a need for clearer definitions and consensus to design better studies in the future.
Article Abstract
Monitoring therapeutic response to neoadjuvant chemotherapy(NAC) is likely to improve NAC effectiveness in breast cancer(BC). Imaging performance seems to vary per tumour subtype(by ER and HER2 status), therefore we performed a systematic review on subtype specific imaging performance in monitoring NAC in BC. Studies examining imaging performance in predicting pathologic complete response(pCR) during NAC in BC subtypes were selected. Per study, negative- and positive predictive value, sensitivity(se) and specificity(sp), AUC and accuracy were derived. Fifteen/106 articles were included. Inter-study variability was revealed in: monitoring interval, response and pCR definitions. In ER-positive/HER2-negative BC, 1F FDG-PET/CT showed se/sp of 38%-89%/74%-100%, MRI showed se/sp of 35%-37%/87%-89%. In triple negative BC, 1F FDG-PET/CT showed se/sp of 0%-79%/95%-100%. 1F FDG-PET/CT showed in ER-positive/HER2-positive BC se/sp of 59%/80% and in ER-negative/HER2-positive 27%/88%. Evidence on imaging performance in monitoring NAC according BC subtypes is lacking. Consensus should be reached in: definitions of pCR, response and monitoring interval before starting well-designed studies.
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| http://dx.doi.org/10.1016/j.critrevonc.2017.02.014 | DOI Listing |
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