Evaluation of Tumor Elasticity and Clinicopathologic Factors Affecting Neoadjuvant Chemotherapy Response in Patients with Breast Cancer
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Purpose: This study aimed to determine the clinicopathologic factors, including tumor elasticity, affecting neoadjuvant chemotherapy response in breast cancer. Methods: Among 95 patients who received neoadjuvant chemotherapy for clinical stage IIa-IIIc primary breast cancer, 75 underwent strain elastography assessments. The patients were divided into soft and hard tumor groups based on the Tsukuba elasticity scoring system. Pathologic factors, including tumor cellularity and stromal characteristics, were evaluated using core needle biopsy specimens collected before neoadjuvant chemotherapy. Pathologic complete response (pCR) was defined as the absence of invasive carcinoma in the breast and axillary lymph nodes. Residual cancer burden (RCB) was also calculated in 79 cases. Results: Twenty-two patients achieved pCR (23.2%). The rates of estrogen receptor (ER) negativity (p=0.04), progesterone receptor (PR) negativity (p=0.03), and nuclear grade 3 (p=0.03) were higher in patients with pCR than those in patients without pCR. The rates of PR negativity (p=0.03), nuclear grade 3 (p=0.01), and high tumor-infiltrating lymphocyte (TIL) levels (p=0.04) were significantly higher in the favorable RCB group (RCB-0 and I) than those in the unfavorable RCB group (RCB-II and III). No significant difference in tumor elasticity was observed between the groups (p=0.30). Hormone receptor (HR) negativity was an independent predictor of favorable RCB in the multivariate analysis (p=0.04). Conclusion: Tumor elasticity was not associated with pCR or RCB. HR negativity was an independent predictor of favorable RCB.
Abstract
Purpose: This study aimed to determine the clinicopathologic factors, including tumor elasticity, affecting neoadjuvant chemotherapy response in breast cancer. Methods: Among 95 patients who received neoadjuvant chemotherapy for clinical stage IIa-IIIc primary breast cancer, 75 underwent strain elastography assessments. The patients were divided into soft and hard tumor groups based on the Tsukuba elasticity scoring system. Pathologic factors, including tumor cellularity and stromal characteristics, were evaluated using core needle biopsy specimens collected before neoadjuvant chemotherapy. Pathologic complete response (pCR) was defined as the absence of invasive carcinoma in the breast and axillary lymph nodes. Residual cancer burden (RCB) was also calculated in 79 cases. Results: Twenty-two patients achieved pCR (23.2%). The rates of estrogen receptor (ER) negativity (p=0.04), progesterone receptor (PR) negativity (p=0.03), and nuclear grade 3 (p=0.03) were higher in patients with pCR than those in patients without pCR. The rates of PR negativity (p=0.03), nuclear grade 3 (p=0.01), and high tumor-infiltrating lymphocyte (TIL) levels (p=0.04) were significantly higher in the favorable RCB group (RCB-0 and I) than those in the unfavorable RCB group (RCB-II and III). No significant difference in tumor elasticity was observed between the groups (p=0.30). Hormone receptor (HR) negativity was an independent predictor of favorable RCB in the multivariate analysis (p=0.04). Conclusion: Tumor elasticity was not associated with pCR or RCB. HR negativity was an independent predictor of favorable RCB.
참고문헌 (31)
- "Clinical practice guidelines in oncology, version 2" (2017)[URL]
- von Minckwitz G, "Definition and impact of pathologic complete re-sponse on prognosis after neoadjuvant chemotherapy in various in-trinsic breast cancer subtypes", J Clin Oncol, 30, pp.1796~1804 (2012)
- Cortazar P, "Pathological complete response and long-term clinical benefit in breast cancer : the CTNeoBC pooled analysis", Lancet, 384, pp.164~172 (2014)
- Boughey JC, "Tumor biology correlates with rates of breast-conserving surgery and pathologic complete response after neoadjuvant chemotherapy for breast cancer : findings from the ACOSOG Z1071(alliance)prospective multicenter clinical trial", Ann Surg, 260, pp.608~614 (2014)
- Gentile LF, "Tumor biology predicts pathologic complete response to neoadju-vant chemotherapy in patients presenting with locally advanced breast cancer", Ann Surg Oncol, 24, pp.3896~3902 (2017)
- Rouzier R, "Breast cancer molecular subtypes respond differ-ently to preoperative chemotherapy", Clin Cancer Res, 11, pp.5678~5685 (2005)
- Shien T, "Clinicopathological features of tumors as predictors of the effi-cacy of primary neoadjuvant chemotherapy for operable breast cancer", World J Surg, 33, pp.44~51 (2009)
- Denkert C, "Tumor-associated lymphocytes as an independent predictor of re-sponse to neoadjuvant chemotherapy in breast cancer", J Clin Oncol, 28, pp.105~113 (2010)
- Yoon Yang Jung, "Histomorphological Factors Predicting the Response to Neoadjuvant Chemotherapy in Triple-Negative Breast Cancer", Journal of Breast Cancer, 19(3), pp.261~267 (2016), 한국유방암학회
- Yamaguchi R, "Tumor-infiltrating lymphocytes are important pathologic pre-dictors for neoadjuvant chemotherapy in patients with breast can-cer", Hum Pathol, 43, pp.1688~1694 (2012)
- Fasching PA, "Ki67, chemotherapy response, and prognosis in breast cancer patients receiving neoadjuvant treatment", BMC Cancer, 11, pp.1~13 (2011)
- MacGrogan G, "Primary chemotherapy in breast invasive carcino-ma : predictive value of the immunohistochemical detection of hor-monal receptors, p53, c-erbB-2, MiB1, pS2 and GST pi", Br J Cancer, 74, pp.1458~1465 (1996)
- MacGrogan G, "DNA topoisomerase II alpha expression and the re-sponse to primary chemotherapy in breast cancer", Br J Cancer, 89, pp.666~671 (2003)
- Buchholz TA, "The nuclear transcription factor kappaB", bcl-2pathway correlates with pathologic complete response to doxorubi-cin-based neoadjuvant chemotherapy in human breast cancer, 2005, pp.11, 8398~8402
- Choi IK, "Strategies to in-crease drug penetration in solid tumors", Front Oncol, 3, pp.193~ (2013)
- Chamming’s F, "Shear wave elastography of tumour growth in a human breast cancer model with pathological correla-tion", Eur Radiol, 23, pp.2079~2086 (2013)
- Lee JH, "Role and clinical usefulness of elastography in small breast masses", Acad Radiol, 18, pp.74~80 (2011)
- Sadigh G, "Ultrasonographic differentiation of malignant from benign breast lesions : a meta-ana-lytic comparison of elasticity and BIRADS scoring", Breast Cancer Res Treat, 133, pp.23~35 (2012)
- Hayashi M, "Evaluation of tumor stiffness by elastography is pre-dictive for pathologic complete response to neoadjuvant chemo-therapy in patients with breast cancer", Ann Surg Oncol, 19, pp.3042~3049 (2012)
- Jing H, "Early evalua-tion of relative changes in tumor stiffness by shear wave elastogra-phy predicts the response to neoadjuvant chemotherapy in patients with breast cancer", J Ultrasound Med, 35, pp.1619~1627 (2016)
- Ma Y, "Comparison of strain and shear-wave ultrasounic elastography in predicting the pathological response to neoadjuvant chemotherapy in breast cancers", Eur Radi-ol, 27, pp.2282~2291 (2017)
- Itoh A, "Breast disease : clinical application of US elastography for diagnosis", Radiology, 239, pp.341~350 (2006)
- Salgado R, "The evaluation of tumor-infiltrating lymphocytes(TILs)in breast cancer : recommendations by an international TILs working group 2014", Ann Oncol, 26, pp.259~271 (2015)
- Symmans WF, "Measurement of residual breast cancer burden to predict sur-vival after neoadjuvant chemotherapy", J Clin Oncol, 25, pp.4414~4422 (2007)
- "Residual cancer burden calculator"[URL]
- Chang JM, "Breast mass evaluation : fac-tors influencing the quality of US elastography", Radiology, 259, pp.59~64 (2011)
- Tong Moon, "Evaluation of Prognostic Factors and Validation of Tumor Response Ratios after Neoadjuvant Chemotherapy in Patients with Breast Cancer", Journal of Breast Disease, 4(2), pp.108~115 (2016), 한국유방암학회[DOI]
- Miyoshi Y, "Low nuclear grade but not cell proliferation pre-dictive of pathological complete response to docetaxel in human breast cancers", J Cancer Res Clin Oncol, 134, pp.561~567 (2008)
- Min Jaegal, "Prognostic Factors in Patients with Locally Advanced Breast Cancer Treated by Neoadjuvant Chemotherapy", Journal of Breast Disease, 7(1), pp.23~29 (2019), 한국유방암학회[DOI]
- Wang J, "Assessment of histologic features and expression of bio-markers in predicting pathologic response to anthracycline-based neoadjuvant chemotherapy in patients with breast carcinoma", Can-cer, 94, pp.3107~3114 (2002)
- Osako T, "High-grade breast cancers include both highly sensitive and highly resistant subsets to cytotoxic chemotherapy", J Cancer Res Clin On-col, 136, pp.1431~1438 (2010)