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Journal of Oncology
Volume 2013 (2013), Article ID 964863, 7 pages
http://dx.doi.org/10.1155/2013/964863
Research Article

Which Imaging Modality Is Superior for Prediction of Response to Neoadjuvant Chemotherapy in Patients with Triple Negative Breast Cancer?

1Department of Surgery, Washington University School of Medicine, 660 S. Euclid Avenue, Campus Box 8109, St. Louis, MO 63110, USA
2Department of Radiology, Washington University School of Medicine, St. Louis, MO 63110, USA
3Department of Surgery, University of Pennsylvania, Philadelphia, PA 19104, USA
4Division of Biostatistics, Washington University School of Medicine, St. Louis, MO 63110, USA

Received 25 October 2012; Revised 16 December 2012; Accepted 14 January 2013

Academic Editor: Gunter Von Minckwitz

Copyright © 2013 Jordan J. Atkins et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background and Objectives. Triple negative breast cancer (TNBC) has been shown to be generally chemosensitive. We sought to investigate the utility of mammography (MMG), ultrasonography (US), and breast magnetic resonance imaging (MRI) in predicting residual disease following neoadjuvant chemotherapy for TNBC. Methods. We identified 148 patients with 151 Stage I–III TNBC treated with neoadjuvant chemotherapy. Residual tumor size was estimated by MMG, US, and/or MRI prior to surgical intervention and compared to the subsequent pathologic residual tumor size. Data were compared using chi-squared test. Results. Of 151 tumors, 44 (29%) did not have imaging performed prior to surgical treatment. Thirty-eight (25%) tumors underwent a pathologic complete response (pCR), while 113 (75%) had residual invasive disease. The imaging modality was accurate to within 1 cm of the final pathologic residual disease in 74 (69%) cases and within 2 cm in 94 (88%) cases. Groups were similar with regards to patient age, race, tumor size and grade, and clinical stage ( ). Accuracy to within 1 cm was the highest for US (83%) and the lowest for MMG (56%) ( ). Conclusions. Breast US and MRI were more accurate than MMG in predicting residual tumor size following neoadjuvant chemotherapy in patients with TNBC. None of the imaging modalities were predictive of a pCR.