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Mammographic density changes during neoadjuvant breast cancer treatment : NeoDense, a prospective study in Sweden

Skarping, Ida LU ; Förnvik, Daniel LU ; Heide-Jørgensen, Uffe ; Sartor, Hanna LU ; Hall, Per ; Zackrisson, Sophia LU and Borgquist, Signe LU (2020) In Breast 53. p.33-41
Abstract

Objectives: To assess if mammographic density (MD) changes during neoadjuvant breast cancer treatment and is predictive of a pathological complete response (pCR). Methods: We prospectively included 200 breast cancer patients assigned to neoadjuvant chemotherapy (NACT) in the NeoDense study (2014–2019). Raw data mammograms were used to assess MD with a fully automated volumetric method and radiologists categorized MD using the Breast Imaging-Reporting and Data System (BI-RADS), 5th Edition. Logistic regression was used to calculate odds ratios (OR) for pCR comparing BI-RADS categories c vs. a, b, and d as well as with a 0.5% change in percent dense volume adjusting for baseline characteristics. Results: The overall median age was 53.1... (More)

Objectives: To assess if mammographic density (MD) changes during neoadjuvant breast cancer treatment and is predictive of a pathological complete response (pCR). Methods: We prospectively included 200 breast cancer patients assigned to neoadjuvant chemotherapy (NACT) in the NeoDense study (2014–2019). Raw data mammograms were used to assess MD with a fully automated volumetric method and radiologists categorized MD using the Breast Imaging-Reporting and Data System (BI-RADS), 5th Edition. Logistic regression was used to calculate odds ratios (OR) for pCR comparing BI-RADS categories c vs. a, b, and d as well as with a 0.5% change in percent dense volume adjusting for baseline characteristics. Results: The overall median age was 53.1 years, and 48% of study participants were premenopausal pre-NACT. A total of 23% (N = 45) of the patients accomplished pCR following NACT. Patients with very dense breasts (BI-RADS d) were more likely to have a positive axillary lymph node status at diagnosis: 89% of the patients with very dense breasts compared to 72% in the entire cohort. A total of 74% of patients decreased their absolute dense volume during NACT. The likelihood of accomplishing pCR following NACT was independent of volumetric MD at diagnosis and change in volumetric MD during treatment. No trend was observed between decreasing density according to BI-RADS and the likelihood of accomplishing pCR following NACT. Conclusions: The majority of patients decreased their MD during NACT. We found no evidence of MD as a predictive marker of pCR in the neoadjuvant setting.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Breast cancer, Breast density, Mammography, Neoadjuvant therapy
in
Breast
volume
53
pages
9 pages
publisher
Churchill Livingstone
external identifiers
  • pmid:32563178
  • scopus:85086601705
ISSN
0960-9776
DOI
10.1016/j.breast.2020.05.013
language
English
LU publication?
yes
id
5d79427a-c2aa-4b2e-8c22-b79a21f6f186
date added to LUP
2020-06-29 10:43:22
date last changed
2020-10-25 03:09:36
@article{5d79427a-c2aa-4b2e-8c22-b79a21f6f186,
  abstract     = {<p>Objectives: To assess if mammographic density (MD) changes during neoadjuvant breast cancer treatment and is predictive of a pathological complete response (pCR). Methods: We prospectively included 200 breast cancer patients assigned to neoadjuvant chemotherapy (NACT) in the NeoDense study (2014–2019). Raw data mammograms were used to assess MD with a fully automated volumetric method and radiologists categorized MD using the Breast Imaging-Reporting and Data System (BI-RADS), 5th Edition. Logistic regression was used to calculate odds ratios (OR) for pCR comparing BI-RADS categories c vs. a, b, and d as well as with a 0.5% change in percent dense volume adjusting for baseline characteristics. Results: The overall median age was 53.1 years, and 48% of study participants were premenopausal pre-NACT. A total of 23% (N = 45) of the patients accomplished pCR following NACT. Patients with very dense breasts (BI-RADS d) were more likely to have a positive axillary lymph node status at diagnosis: 89% of the patients with very dense breasts compared to 72% in the entire cohort. A total of 74% of patients decreased their absolute dense volume during NACT. The likelihood of accomplishing pCR following NACT was independent of volumetric MD at diagnosis and change in volumetric MD during treatment. No trend was observed between decreasing density according to BI-RADS and the likelihood of accomplishing pCR following NACT. Conclusions: The majority of patients decreased their MD during NACT. We found no evidence of MD as a predictive marker of pCR in the neoadjuvant setting.</p>},
  author       = {Skarping, Ida and Förnvik, Daniel and Heide-Jørgensen, Uffe and Sartor, Hanna and Hall, Per and Zackrisson, Sophia and Borgquist, Signe},
  issn         = {0960-9776},
  language     = {eng},
  pages        = {33--41},
  publisher    = {Churchill Livingstone},
  series       = {Breast},
  title        = {Mammographic density changes during neoadjuvant breast cancer treatment : NeoDense, a prospective study in Sweden},
  url          = {http://dx.doi.org/10.1016/j.breast.2020.05.013},
  doi          = {10.1016/j.breast.2020.05.013},
  volume       = {53},
  year         = {2020},
}