The use of breast ultrasound for prediction of pathologic complete response in different subtypes of early breast cancer within the WSG-ADAPT subtrials.

Jun 28, 2021

Contributor: Monika Graeser,Nadia Harbeck,Oleg Gluz,Rachel Würstlein,Christine Zu Eulenburg,Claudia Schumacher,Eva-Maria Grischke,Helmut Forstbauer,Moritz Dimpfl,Michael Braun,Matthias Christgen,Hans Heinrich Kreipe,Jochem Potenberg,Raquel von Schumann,Bahriye Aktas,Cornelia Kolberg-Liedtke,Sherko Kümmel,Ulrike Nitz

The use of breast ultrasound for prediction of pathologic complete response in different subtypes of early breast cancer within the WSG-ADAPT subtrials.

We assessed the value of breast ultrasound (US) performed at week 3 and 6 and at the end (EOT) of neoadjuvant therapy (NAT) for prediction of pathologic complete response (pCR, ypT0/is ypN0) in patients with HR+/HER2+, HR-/HER2-or HR-/HER2+ early breast cancer enrolled in the WSG-ADAPT subtrials.
US was performed at week 3 and 6 of NAT and at EOT in 401, 517, and 553 patients, respectively. Tumors with complete or partial response by US (RECIST 1.1) were classified as responders and those with stable or progressive disease as non-responders.
pCR rate was higher in US responders than in non-responders. US tended to yield the highest positive predictive value in HR-/HER2+ (69%) and HR-/HER2-tumors (65%) at week 3, and the highest negative predictive value in HR+/HER2+ tumors at week 6 and at EOT (88.9% and 86.9%, respectively) and in HR-/HER2-tumors at EOT (87.9%). Multivariable analysis of patients with US at week 3 and 6 identified tumor subtype (HR-/HER2+ vs HR+/HER2+; odds ratio (OR) 2.77, 95%CI 1.45-5.29, and OR 4.17, 95%CI 2.26-7.68, respectively) and each 10% change in lesion dimension on US from baseline (OR 1.15, 95%CI 1.08-1.24, and OR 1.25, 95%CI 1.16-1.35, respectively) as parameters associated with pCR.
Our data support the use of week 3 and EOT US for prediction of pCR in response-guided NAT and in planning of breast-conserving surgery. Change in tumor diameter on US as a continuous variable could be a valuable alternative to categorical RECIST 1.1 criteria.

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

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About The Expert

Monika Graeser

West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; Breast Center Niederrhein, Ev. Hospital Bethesda, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; Department of Gynecology, University Medical Center Hamburg, Martinistrasse 52, 20251, Hamburg, Germany. Electronic address: monika.graeser@wsg-online.com.

Nadia Harbeck

West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; Breast Center, Department of Gynecology and Obstetrics and CCCLMU, LMU University Hospital, Marchioninistrasse 15, 81377, Munich, Germany.

Oleg Gluz

West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; Breast Center Niederrhein, Ev. Hospital Bethesda, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; University Hospital Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.

Rachel Würstlein

West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; Breast Center, Department of Gynecology and Obstetrics and CCCLMU, LMU University Hospital, Marchioninistrasse 15, 81377, Munich, Germany.

Christine Zu Eulenburg

West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany.

Claudia Schumacher

Breast Center, St. Elisabeth Hospital, Werthmannstrasse 1, 50935, Cologne, Germany.

Eva-Maria Grischke

Women’s Clinic, University Clinics Tuebingen, Calwerstrasse 7, 72076, Tuebingen, Germany.

Helmut Forstbauer

Practice Network Troisdorf, Schlossstrasse 18, 53840, Troisdorf, Germany.

Moritz Dimpfl

Breast Center, Department of Gynecology and Obstetrics and CCCLMU, LMU University Hospital, Marchioninistrasse 15, 81377, Munich, Germany.

Michael Braun

Breast Center, Rotkreuz Clinics Munich, Nymphenburger Strasse 163, 80634, Munich, Germany.

Matthias Christgen

Institute of Pathology, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.

Hans Heinrich Kreipe

Institute of Pathology, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625, Hannover, Germany.

Jochem Potenberg

Ev. Waldkrankenhaus Berlin, Stadtrandstrasse 555, 13589, Berlin, Germany.

Raquel von Schumann

Breast Center Niederrhein, Ev. Hospital Bethesda, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany.

Bahriye Aktas

Women’s Clinic, University Clinics Essen, Hufelandstrasse 55, 45147, Essen, Germany; Women’s Clinic, University Clinics Leipzig, Liebigstrasse 20a, 04103, Leipzig, Germany.

Cornelia Kolberg-Liedtke

Women’s Clinic, University Clinics Essen, Hufelandstrasse 55, 45147, Essen, Germany; University Hospital Charité, Humboldt University, Chariteplatz 1, 10117, Berlin, Germany.

Sherko Kümmel

West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; University Hospital Charité, Humboldt University, Chariteplatz 1, 10117, Berlin, Germany; Breast Unit, Kliniken Essen-Mitte, Henricistrasse 92, 45136, Essen, Germany.

Ulrike Nitz

West German Study Group, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany; Breast Center Niederrhein, Ev. Hospital Bethesda, Ludwig-Weber-Strasse 15, 41061, Moenchengladbach, Germany.

References

PubMed