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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 11/2006

01-11-2006

Accuracy of the Combination of Mammography and Sonography in Predicting Tumor Response in Breast Cancer Patients After Neoadjuvant Chemotherapy

Authors: Florentia Peintinger, MD, Henry M. Kuerer, MD, PhD, Keith Anderson, MS, Judy C. Boughey, MD, Funda Meric-Bernstam, MD, S. Eva Singletary, MD, Kelly K. Hunt, MD, Gary J. Whitman, MD, Tanya Stephens, MD, Aman U. Buzdar, MD, Marjorie C. Green, MD, W. Fraser Symmans, MD

Published in: Annals of Surgical Oncology | Issue 11/2006

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Abstract

Background

Residual tumor size after neoadjuvant chemotherapy is an important consideration in surgical planning. We examined the accuracy of the combination of mammography and sonography in predicting pathologic residual tumor size.

Methods

Tumor size was evaluated by physical examination, mammography, and sonography at diagnosis and before surgery in 162 breast cancer patients who received neoadjuvant chemotherapy. Agreement between the predicted and the pathologic responses and the predicted and the pathologic tumor sizes was calculated. The effect of invasive lobular carcinoma, high nuclear grade, hormone receptor positivity, and the presence of an extensive intraductal component on the accuracy of mammography and sonography in predicting pathologic residual tumor size was analyzed.

Results

Forty-two patients (25.9%) had a pathologic complete response (pCR). Overall agreement between predicted and pathologic responses was 53% for physical examination, 67% for mammography plus sonography, and 63% for physical examination plus mammography and sonography. The sensitivity of mammography and sonography in predicting pCR was 78.6%, and the specificity was 92.5%; the accuracy was 88.9%. Residual tumor size determined by mammography and sonography correlated with pathologic residual tumor size (r = .662); pathologic tumor size was within .5 cm of predicted in 69.1% of patients. Multivariate analysis showed that pathologic residual tumor size was underestimated for lobular carcinoma and overestimated for poorly differentiated tumors.

Conclusions

The combination of mammography and sonography has a high accuracy in predicting pCR after neoadjuvant chemotherapy. Agreement of residual tumor size in mammography and sonography with pathologic residual tumor size was moderate.
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Metadata
Title
Accuracy of the Combination of Mammography and Sonography in Predicting Tumor Response in Breast Cancer Patients After Neoadjuvant Chemotherapy
Authors
Florentia Peintinger, MD
Henry M. Kuerer, MD, PhD
Keith Anderson, MS
Judy C. Boughey, MD
Funda Meric-Bernstam, MD
S. Eva Singletary, MD
Kelly K. Hunt, MD
Gary J. Whitman, MD
Tanya Stephens, MD
Aman U. Buzdar, MD
Marjorie C. Green, MD
W. Fraser Symmans, MD
Publication date
01-11-2006
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 11/2006
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-006-9086-9

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