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Mammographic density in relation to breast cancer recurrence and survival in women receiving neoadjuvant chemotherapy

Zdanowski, Anna ; Sartor, Hanna LU ; Feldt, Maria LU and Skarping, Ida LU orcid (2023) In Frontiers in Oncology 13.
Abstract

Objective: The association between mammographic density (MD) and breast cancer (BC) recurrence and survival remains unclear. Patients receiving neoadjuvant chemotherapy (NACT) are in a vulnerable situation with the tumor within the breast during treatment. This study evaluated the association between MD and recurrence/survival in BC patients treated with NACT. Methods: Patients with BC treated with NACT in Sweden (2005–2016) were retrospectively included (N=302). Associations between MD (Breast Imaging-Reporting and Data System (BI-RADS) 5th Edition) and recurrence-free/BC-specific survival at follow-up (Q1 2022) were addressed. Hazard ratios (HRs) for recurrence/BC-specific survival (BI-RADS a/b/c vs. d) were estimated using... (More)

Objective: The association between mammographic density (MD) and breast cancer (BC) recurrence and survival remains unclear. Patients receiving neoadjuvant chemotherapy (NACT) are in a vulnerable situation with the tumor within the breast during treatment. This study evaluated the association between MD and recurrence/survival in BC patients treated with NACT. Methods: Patients with BC treated with NACT in Sweden (2005–2016) were retrospectively included (N=302). Associations between MD (Breast Imaging-Reporting and Data System (BI-RADS) 5th Edition) and recurrence-free/BC-specific survival at follow-up (Q1 2022) were addressed. Hazard ratios (HRs) for recurrence/BC-specific survival (BI-RADS a/b/c vs. d) were estimated using Cox regression analysis and adjusted for age, estrogen receptor status, human epidermal growth factor receptor 2 status, axillary lymph node status, tumor size, and complete pathological response. Results: A total of 86 recurrences and 64 deaths were recorded. The adjusted models showed that patients with BI-RADS d vs. BI-RADS a/b/c had an increased risk of recurrence (HR 1.96 (95% confidence interval (CI) 0.98–3.92)) and an increased risk of BC-specific death (HR 2.94 (95% CI 1.43–6.06)). Conclusion: These findings raise questions regarding personalized follow-up for BC patients with extremely dense breasts (BI-RADS d) pre-NACT. More extensive studies are required to confirm our findings.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
breast cancer neoadjuvant therapy, breast density, imaging, mammographic density (MD), survival analysis (MeSH NLM)
in
Frontiers in Oncology
volume
13
article number
1177310
publisher
Frontiers Media S. A.
external identifiers
  • pmid:37388229
  • scopus:85163719516
ISSN
2234-943X
DOI
10.3389/fonc.2023.1177310
language
English
LU publication?
yes
id
19a693db-d6dc-47a6-973c-309a12fd3c66
date added to LUP
2023-10-10 13:54:31
date last changed
2024-04-19 02:11:33
@article{19a693db-d6dc-47a6-973c-309a12fd3c66,
  abstract     = {{<p>Objective: The association between mammographic density (MD) and breast cancer (BC) recurrence and survival remains unclear. Patients receiving neoadjuvant chemotherapy (NACT) are in a vulnerable situation with the tumor within the breast during treatment. This study evaluated the association between MD and recurrence/survival in BC patients treated with NACT. Methods: Patients with BC treated with NACT in Sweden (2005–2016) were retrospectively included (N=302). Associations between MD (Breast Imaging-Reporting and Data System (BI-RADS) 5<sup>th</sup> Edition) and recurrence-free/BC-specific survival at follow-up (Q1 2022) were addressed. Hazard ratios (HRs) for recurrence/BC-specific survival (BI-RADS a/b/c vs. d) were estimated using Cox regression analysis and adjusted for age, estrogen receptor status, human epidermal growth factor receptor 2 status, axillary lymph node status, tumor size, and complete pathological response. Results: A total of 86 recurrences and 64 deaths were recorded. The adjusted models showed that patients with BI-RADS d vs. BI-RADS a/b/c had an increased risk of recurrence (HR 1.96 (95% confidence interval (CI) 0.98–3.92)) and an increased risk of BC-specific death (HR 2.94 (95% CI 1.43–6.06)). Conclusion: These findings raise questions regarding personalized follow-up for BC patients with extremely dense breasts (BI-RADS d) pre-NACT. More extensive studies are required to confirm our findings.</p>}},
  author       = {{Zdanowski, Anna and Sartor, Hanna and Feldt, Maria and Skarping, Ida}},
  issn         = {{2234-943X}},
  keywords     = {{breast cancer neoadjuvant therapy; breast density; imaging; mammographic density (MD); survival analysis (MeSH NLM)}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Frontiers Media S. A.}},
  series       = {{Frontiers in Oncology}},
  title        = {{Mammographic density in relation to breast cancer recurrence and survival in women receiving neoadjuvant chemotherapy}},
  url          = {{http://dx.doi.org/10.3389/fonc.2023.1177310}},
  doi          = {{10.3389/fonc.2023.1177310}},
  volume       = {{13}},
  year         = {{2023}},
}