Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 9/2012

01-09-2012 | Breast Oncology

Evaluation of Tumor Stiffness by Elastography Is Predictive for Pathologic Complete Response to Neoadjuvant Chemotherapy in Patients with Breast Cancer

Authors: Mitsuhiro Hayashi, MD, Yutaka Yamamoto, MD, PhD, Mutsuko Ibusuki, MD, PhD, Saori Fujiwara, MD, Satoko Yamamoto, MD, Saori Tomita, MD, Masahiro Nakano, MD, Keiichi Murakami, MD, Ken-ichi Iyama, MD, PhD, Hirotaka Iwase, MD, PhD

Published in: Annals of Surgical Oncology | Issue 9/2012

Login to get access

Abstract

Background

Breast elastography (EG), which can objectively evaluate tumor stiffness, has been useful for differentiation of benign and malignant breast lesions. However, the value of EG for prediction of response to systemic therapy is poorly understood.

Methods

The baseline evaluations of EG in 55 patients who received neoadjuvant chemotherapy were reviewed. We investigated the correlation between tumor stiffness and response to neoadjuvant chemotherapy. Tumor stiffness was evaluated by the Tsukuba elasticity scoring system.

Results

The mean EG scores were significant lower for the clinical and pathologic complete response (pCR) groups than for the others. When we categorized patients into two groups according to tumor stiffness, 26 patients were assigned to the low EG group (soft, scores from 1 to 3) and 29 patients were assigned to the high EG group (hard, score 4 and 5). The low EG group had significantly higher clinical complete response and pCR rates than the high EG group (clinical complete response, low EG group 38 % vs. high EG group 10 %, P = 0.024; pCR, low EG group 50 % vs. high EG group 14 %, P = 0.003, respectively). Furthermore, multivariate analysis indicated that estrogen receptor, human epidermal growth factor receptor 2, and low EG (odds ratio 13.04, 95 % confidence interval 1.19–458.28, P = 0.035) were independent predictive factors of pCR.

Conclusions

Tumor stiffness evaluated by EG bears predictive potential for response to neoadjuvant chemotherapy. Stiffness evaluated by EG may be recognized as a clinically significant tumor characteristic, comparable to other data obtained by functional imaging techniques.
Literature
1.
Itoh A, Ueno E, Tohno E, et al. Breast disease: clinical application of US elastography for diagnosis. Radiology. 2006;239:341–50.PubMedCrossRef
2.
Sadigh G, Carlos RC, Neal CH, Dwamena BA. Ultrasonographic differentiation of malignant from benign breast lesions: a meta-analytic comparison of elasticity and BIRADS scoring. Breast Cancer Res Treat (in press).
3.
Gong X, Xu Q, Xu Z, Xiong P, Yan W, Chen Y. Real-time elastography for the differentiation of benign and malignant breast lesions: a meta-analysis. Breast Cancer Res Treat. 2011;130:11–8.PubMedCrossRef
4.
Scaperrotta G, Ferranti C, Costa C, et al. Role of sonoelastography in non-palpable breast lesions. Eur Radiol. 2008;18:2381–9.PubMedCrossRef
5.
Levental KR, Yu H, Kass L, et al. Matrix crosslinking forces tumor progression by enhancing integrin signaling. Cell. 2009;139:891–906.PubMedCrossRef
6.
Butcher DT, Alliston T, Weaver VM. A tense situation: forcing tumour progression. Nat Rev Cancer. 2009;9:108–22.PubMedCrossRef
7.
Kaufmann M, von Minckwitz G, Mamounas EP, et al. Recommendations from an international consensus conference on the current status and future of neoadjuvant systemic therapy in primary breast cancer. Ann Surg Oncol (in press).
8.
Mauri D, Pavlidis N, Ioannidis JP. Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis. J Natl Cancer Inst. 2005;97:188–94.PubMedCrossRef
9.
Gralow JR, Burstein HJ, Wood W, et al. Preoperative therapy in invasive breast cancer: pathologic assessment and systemic therapy issues in operable disease. J Clin Oncol. 2008;26:814–9.PubMedCrossRef
10.
Rastogi P, Anderson SJ, Bear HD, et al. Preoperative chemotherapy: updates of National surgical adjuvant breast and bowel project protocols B-18 and B-27. J Clin Oncol. 2008;26:778–85.PubMedCrossRef
11.
Nishimura R, Osako T, Okumura Y, Hayashi M, Arima N. Clinical significance of Ki-67 in neoadjuvant chemotherapy for primary breast cancer as a predictor for chemosensitivity and for prognosis. Breast Cancer. 2010;17:269–75.PubMedCrossRef
12.
Toi M, Nakamura S, Kuroi K, et al. Phase II study of preoperative sequential FEC and docetaxel predicts of pathological response and disease free survival. Breast Cancer Res Treat. 2008;110:531–9.PubMedCrossRef
13.
Straver ME, Glas AM, Hannemann J, et al. The 70-gene signature as a response predictor for neoadjuvant chemotherapy in breast cancer. Breast Cancer Res Treat. 2010;119:551–8.PubMedCrossRef
14.
Gianni L, Zambetti M, Clark K, et al. Gene expression profiles in paraffin-embedded core biopsy tissue predict response to chemotherapy in women with locally advanced breast cancer. J Clin Oncol. 2005;23:7265–77.PubMedCrossRef
15.
Park SH, Moon WK, Cho N, et al. Diffusion-weighted MR imaging: pretreatment prediction of response to neoadjuvant chemotherapy in patients with breast cancer. Radiology. 2010;257:56–63.PubMedCrossRef
16.
Smith IC, Welch AE, Hutcheon AW, et al. Positron emission tomography using [(18)F]-fluorodeoxy-d-glucose to predict the pathologic response of breast cancer to primary chemotherapy. J Clin Oncol. 2000;18:1676–88.PubMed
17.
Fangberget A, Nilsen LB, Hole KH, et al. Neoadjuvant chemotherapy in breast cancer–response evaluation and prediction of response to treatment using dynamic contrast-enhanced and diffusion-weighted MR imaging. Eur Radiol. 2011;21:1188–99.PubMedCrossRef
18.
Uematsu T, Kasami M, Yuen S. Neoadjuvant chemotherapy for breast cancer: correlation between the baseline MR imaging findings and responses to therapy. Eur Radiol. 2010;20:2315–22.PubMedCrossRef
19.
Iacconi C, Giannelli M, Marini C, et al. The role of mean diffusivity (MD) as a predictive index of the response to chemotherapy in locally advanced breast cancer: a preliminary study. Eur Radiol. 2010;20:303–8.PubMedCrossRef
20.
Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst. 2000;92:205–16.PubMedCrossRef
21.
Kurosumi M, Akashi-Tanaka S, Akiyama F, et al. Histopathological criteria for assessment of therapeutic response in breast cancer (2007 version). Breast Cancer. 2008;15:5–7.PubMedCrossRef
22.
Buzdar AU, Ibrahim NK, Francis D, et al. Significantly higher pathologic complete remission rate after neoadjuvant therapy with trastuzumab, paclitaxel, and epirubicin chemotherapy: results of a randomized trial in human epidermal growth factor receptor 2-positive operable breast cancer. J Clin Oncol. 2005;23:3676–85.PubMedCrossRef
23.
Schrader J, Gordon-Walker TT, Aucott RL, et al. Matrix stiffness modulates proliferation, chemotherapeutic response, and dormancy in hepatocellular carcinoma cells. Hepatology. 2011;53:1192–205.PubMedCrossRef
24.
Hayashi M, Kai K, Okumura Y, et al. Shift in cytotoxic target from estrogen receptor–positive to estrogen receptor-negative breast cancer cells by trastuzumab in combination with taxane-based chemotherapy. Oncol Lett. 2011;2:303–8.PubMed
25.
Ulrich TA, de Juan Pardo EM, Kumar S. The mechanical rigidity of the extracellular matrix regulates the structure, motility, and proliferation of glioma cells. Cancer Res. 2009;69:4167–74.PubMedCrossRef
26.
Cho N, Moon WK, Chang JM, et al. Sonoelastographic lesion stiffness: preoperative predictor of the presence of an invasive focus in nonpalpable DCIS diagnosed at US-guided needle biopsy. Eur Radiol. 2011;21:1618–27.PubMedCrossRef
27.
Chang JM, Moon WK, Cho N, Kim SJ. Breast mass evaluation: factors influencing the quality of US elastography. Radiology. 2011;259:59–64.PubMedCrossRef
28.
Iwase H. Current topics and perspectives on the use of aromatase inhibitors in the treatment of breast cancer. Breast Cancer. 2008;15:278–90.PubMedCrossRef
29.
Li SP, Makris A, Beresford MJ, et al. Use of dynamic contrast-enhanced MR imaging to predict survival in patients with primary breast cancer undergoing neoadjuvant chemotherapy. Radiology. 2011;260:68–78.PubMedCrossRef
30.
Kumar A, Kumar R, Seenu V, et al. The role of 18F-FDG PET/CT in evaluation of early response to neoadjuvant chemotherapy in patients with locally advanced breast cancer. Eur Radiol. 2009;19:1347–57.PubMedCrossRef
31.
Rousseau C, Devillers A, Sagan C, et al. Monitoring of early response to neoadjuvant chemotherapy in stage II and III breast cancer by [18F]fluorodeoxyglucose positron emission tomography. J Clin Oncol. 2006;24:5366–72.PubMedCrossRef
32.
Dowsett M, Smith IE, Ebbs SR, et al. Short-term changes in Ki-67 during neoadjuvant treatment of primary breast cancer with anastrozole or tamoxifen alone or combined correlate with recurrence-free survival. Clin Cancer Res. 2005;11:951s–8s.PubMed
Metadata
Title
Evaluation of Tumor Stiffness by Elastography Is Predictive for Pathologic Complete Response to Neoadjuvant Chemotherapy in Patients with Breast Cancer
Authors
Mitsuhiro Hayashi, MD
Yutaka Yamamoto, MD, PhD
Mutsuko Ibusuki, MD, PhD
Saori Fujiwara, MD
Satoko Yamamoto, MD
Saori Tomita, MD
Masahiro Nakano, MD
Keiichi Murakami, MD
Ken-ichi Iyama, MD, PhD
Hirotaka Iwase, MD, PhD
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 9/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-012-2343-1

Other articles of this Issue 9/2012

Annals of Surgical Oncology 9/2012 Go to the issue

Translational Research and Biomarkers

MicroRNA-10b is a Prognostic Indicator in Colorectal Cancer and Confers Resistance to the Chemotherapeutic Agent 5-Fluorouracil in Colorectal Cancer Cells

Translational Research and Biomarkers

Telomere-Specific Reverse Transcriptase (hTERT) and Cell-free RNA in Plasma as Predictors of Pathologic Tumor Response in Rectal Cancer Patients Receiving Neoadjuvant Chemoradiotherapy

Healthcare Policy and Outcomes

A Multi-institutional Study of Pancreatic Cancer in Harris County, Texas: Race Predicts Treatment and Survival

Hepatobiliary Tumors

Coexpression of Stemness Factors Oct4 and Nanog Predict Liver Resection

Hepatobiliary Tumors

Impact of Obesity and Body Fat Distribution on Survival After Pancreaticoduodenectomy for Pancreatic Adenocarcinoma

Translational Research and Biomarkers

Novel Multiple Apoptotic Mechanism of Shikonin in Human Glioma Cells