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Mammographic density is a potential predictive marker of pathological response after neoadjuvant chemotherapy in breast cancer

Skarping, Ida LU ; Förnvik, Daniel LU ; Sartor, Hanna LU ; Heide-Jørgensen, Uffe ; Zackrisson, Sophia LU and Borgquist, Signe LU (2019) In BMC Cancer 19(1). p.1272-1272
Abstract

BACKGROUND: Our aim is to study if mammographic density (MD) prior to neoadjuvant chemotherapy is a predictive factor in accomplishing a pathological complete response (pCR) in neoadjuvant-treated breast cancer patients.

METHODS: Data on all neoadjuvant treated breast cancer patients in Southern Sweden (2005-2016) were retrospectively identified, with patient and tumor characteristics retrieved from their medical charts. Diagnostic mammograms were used to evaluate and score MD as categorized by breast composition with the Breast Imaging-Reporting and Data System (BI-RADS) 5th edition. Logistic regression was used in complete cases to assess the odds ratios (OR) for pCR compared to BI-RADS categories (a vs b-d), adjusting for... (More)

BACKGROUND: Our aim is to study if mammographic density (MD) prior to neoadjuvant chemotherapy is a predictive factor in accomplishing a pathological complete response (pCR) in neoadjuvant-treated breast cancer patients.

METHODS: Data on all neoadjuvant treated breast cancer patients in Southern Sweden (2005-2016) were retrospectively identified, with patient and tumor characteristics retrieved from their medical charts. Diagnostic mammograms were used to evaluate and score MD as categorized by breast composition with the Breast Imaging-Reporting and Data System (BI-RADS) 5th edition. Logistic regression was used in complete cases to assess the odds ratios (OR) for pCR compared to BI-RADS categories (a vs b-d), adjusting for patient and pre-treatment tumor characteristics.

RESULTS: A total of 302 patients were included in the study population, of which 57 (18.9%) patients accomplished pCR following neoadjuvant chemotherapy. The number of patients in the BI-RADS category a, b, c, and d were separately 16, 120, 140, and 26, respectively. In comparison to patients with BI-RADS breast composition a, patients with denser breasts had a lower OR of accomplishing pCR: BI-RADS b 0.32 (95%CI 0.07-0.1.5), BI-RADS c 0.30 (95%CI 0.06-1.45), and BI-RADS d 0.06 (95%CI 0.01-0.56). These associations were measured with lower point estimates, but wider confidence interval, in premenopausal patients; OR of accomplishing pCR for BI-RADS d in comparison to BI-RADS a: 0.03 (95%CI 0.00-0.76).

CONCLUSIONS: The likelihood of accomplishing pCR is indicated to be lower in breast cancer patients with higher MD, which need to be analysed in future studies for improved clinical decision-making regarding neoadjuvant treatment.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Adult, Aged, Breast/diagnostic imaging, Breast Density, Breast Neoplasms/diagnosis, Clinical Decision-Making, Female, Humans, Middle Aged, Neoadjuvant Therapy, Predictive Value of Tests, Prognosis, Retrospective Studies, Sweden, Treatment Outcome
in
BMC Cancer
volume
19
issue
1
pages
1272 - 1272
publisher
BioMed Central (BMC)
external identifiers
  • scopus:85077305733
  • pmid:31888552
ISSN
1471-2407
DOI
10.1186/s12885-019-6485-4
language
English
LU publication?
yes
id
27e7ec81-ecf1-47ea-967a-ca7ff02e8cf3
date added to LUP
2020-09-29 11:17:50
date last changed
2021-04-06 02:57:00
@article{27e7ec81-ecf1-47ea-967a-ca7ff02e8cf3,
  abstract     = {<p>BACKGROUND: Our aim is to study if mammographic density (MD) prior to neoadjuvant chemotherapy is a predictive factor in accomplishing a pathological complete response (pCR) in neoadjuvant-treated breast cancer patients.</p><p>METHODS: Data on all neoadjuvant treated breast cancer patients in Southern Sweden (2005-2016) were retrospectively identified, with patient and tumor characteristics retrieved from their medical charts. Diagnostic mammograms were used to evaluate and score MD as categorized by breast composition with the Breast Imaging-Reporting and Data System (BI-RADS) 5th edition. Logistic regression was used in complete cases to assess the odds ratios (OR) for pCR compared to BI-RADS categories (a vs b-d), adjusting for patient and pre-treatment tumor characteristics.</p><p>RESULTS: A total of 302 patients were included in the study population, of which 57 (18.9%) patients accomplished pCR following neoadjuvant chemotherapy. The number of patients in the BI-RADS category a, b, c, and d were separately 16, 120, 140, and 26, respectively. In comparison to patients with BI-RADS breast composition a, patients with denser breasts had a lower OR of accomplishing pCR: BI-RADS b 0.32 (95%CI 0.07-0.1.5), BI-RADS c 0.30 (95%CI 0.06-1.45), and BI-RADS d 0.06 (95%CI 0.01-0.56). These associations were measured with lower point estimates, but wider confidence interval, in premenopausal patients; OR of accomplishing pCR for BI-RADS d in comparison to BI-RADS a: 0.03 (95%CI 0.00-0.76).</p><p>CONCLUSIONS: The likelihood of accomplishing pCR is indicated to be lower in breast cancer patients with higher MD, which need to be analysed in future studies for improved clinical decision-making regarding neoadjuvant treatment.</p>},
  author       = {Skarping, Ida and Förnvik, Daniel and Sartor, Hanna and Heide-Jørgensen, Uffe and Zackrisson, Sophia and Borgquist, Signe},
  issn         = {1471-2407},
  language     = {eng},
  month        = {12},
  number       = {1},
  pages        = {1272--1272},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Cancer},
  title        = {Mammographic density is a potential predictive marker of pathological response after neoadjuvant chemotherapy in breast cancer},
  url          = {http://dx.doi.org/10.1186/s12885-019-6485-4},
  doi          = {10.1186/s12885-019-6485-4},
  volume       = {19},
  year         = {2019},
}