ROLE OF MAMMOGRAPHY IN RESPONSE ASSESSMENT FOLLOWING NEO-ADJUVANT CHEMOTHERAPY IN LOCALLY ADVANCED BREAST CARCINOMA: EXPERIENCE FROM A TERTIARY CARE CENTER

Bidyut Biswas, MD Asif Ali, Shatanik Mondal, Linkon Biswas
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Abstract

Objectives: Neo-adjuvant chemotherapy (NACT) has an important role in the treatment of locally advanced breast carcinoma (LABC). In this study, we analyzed the efficacy of mammography in response assessment of NACT in patients with LABC and its correlation with histopathological reports. Methods: Eighty patients with LABC underwent clinical examination and mammography at first. Then, after receiving three cycles of NACT, mammography and clinical examination were done again to evaluate the response to NACT. Patients with at least a partial response underwent radical surgery. Then, we correlate the findings of histopathological reports with that of post-NACT mammography findings. Results: After three cycles of NACT, mammography detected complete response (CR) in 20% (n=28) patients and partial response (PR) in 70% (n=48) patients. Clinical examination overestimated the CR to be 45% and underestimated PR to be 50%. Histopathological examination (HPE) showed complete pathological response in 25 specimens and in rest 51 cases HPE revealed residual tumor. Mammography overestimated the pathological complete response by 4% (three patients). Conclusion: It can be said that mammography can be used as an effective imaging tool for response assessment after NACT, especially in resource-limited setups.
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乳房 X 线照相术在局部晚期乳腺癌新辅助化疗后的反应评估中的作用:一家三级医疗中心的经验
目的:新辅助化疗(NACT)在局部晚期乳腺癌(LABC)的治疗中发挥着重要作用。在这项研究中,我们分析了乳腺X光检查在评估LABC患者对新辅助化疗反应中的有效性及其与组织病理学报告的相关性:方法:80 名 LABC 患者首先接受临床检查和乳腺 X 光检查。然后,在接受三个周期的 NACT 治疗后,再次进行乳房 X 光检查和临床检查,以评估对 NACT 的反应。至少有部分反应的患者接受根治手术。然后,我们将组织病理学报告结果与NACT后的乳腺X光检查结果进行对比:结果:经过三个周期的 NACT 治疗后,20%(28 例)的患者通过乳腺 X 射线检查发现了完全反应(CR),70%(48 例)的患者通过乳腺 X 射线检查发现了部分反应(PR)。临床检查高估了 45% 的 CR,低估了 50% 的 PR。组织病理学检查(HPE)显示,25 例标本的病理反应为完全反应,其余 51 例标本的病理反应为肿瘤残留。乳腺 X 线照相术高估了 4% 的病理完全反应(3 例患者):可以说,乳腺X光检查可作为一种有效的成像工具,用于NACT术后反应评估,尤其是在资源有限的情况下。
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