Open Access

The role of molecular breast imaging in predicting complete tumor response to treatment and residual tumor extent following neoadjuvant therapy

  • Authors:
    • Susanna Nuvoli
    • Sarah Galassi
    • Ilaria Gelo
    • Gaia Rocchitta
    • Alessandro  Fancellu
    • Pier Andrea Serra
    • Giuseppe Madeddu
    • Angela Spanu
  • View Affiliations

  • Published online on: March 6, 2018     https://doi.org/10.3892/or.2018.6299
  • Pages: 2055-2062
  • Copyright: © Nuvoli et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The aim of the present study was to investigate the usefulness of molecular breast imaging (MBI) in predicting complete tumor response to treatment and residual tumor extent following neoadjuvant therapy. A consecutive series of 43 female patients with large or locally advanced primary breast cancer, scheduled for surgery following neoadjuvant therapy, was retrospectively reviewed. Prior to surgery, all patients underwent MBI using a high‑resolution semiconductor‑based device for image acquisition. MBI data were correlated with surgical histopathological findings. Spearman's correlation coefficient was calculated to assess differences in residual tumor size with MBI and histopathological examination. From the images obtained using MBI, 7 patients were negative for residual tumors with pathological complete response (specificity, 100%) and positive in 34/36 patients with residual disease (sensitivity, 94.4%), including 26/27 patients with unifocal and 8/9 patients with multicentric/multifocal tumors, 5 of which exhibited multiple microscopic foci scattered in a fibrotic area. Overall accuracy was 95.3% and the positive predictive value (PPV) and negative predictive value (NPV) were 100 and 77.8%, respectively. MBI was false‑negative in one patient with a 2.5‑cm invasive ductal carcinoma located close to the chest wall and in one patient with microscopic foci of epithelial carcinoma. In the patients with unifocal residual tumors, correlation of tumor size between MBI and histopathology was r=0.981 (P<0.0001); however, MBI overestimated the number of lesions in one of these cases. In the patients with multifocal/multicentric tumors, MBI adequately assessed residual tumor extent in 5/8 positive cases, overestimating the number of lesions in one case and underestimating tumor extent in 2 further cases with microscopic foci scattered in a fibrotic area. MBI proved to be a highly accurate diagnostic tool in predicting complete tumor response to neoadjuvant therapy and residual tumor extent, correlating with surgical histopathological findings in 86% of overall cases. A positive result was always associated with the presence of residual disease and MBI tumor size was strongly correlated with histopathological analysis mainly in unifocal residual tumors.
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May-2018
Volume 39 Issue 5

Print ISSN: 1021-335X
Online ISSN:1791-2431

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Spandidos Publications style
Nuvoli S, Galassi S, Gelo I, Rocchitta G, Fancellu A, Serra PA, Madeddu G and Spanu A: The role of molecular breast imaging in predicting complete tumor response to treatment and residual tumor extent following neoadjuvant therapy. Oncol Rep 39: 2055-2062, 2018.
APA
Nuvoli, S., Galassi, S., Gelo, I., Rocchitta, G., Fancellu, A., Serra, P.A. ... Spanu, A. (2018). The role of molecular breast imaging in predicting complete tumor response to treatment and residual tumor extent following neoadjuvant therapy. Oncology Reports, 39, 2055-2062. https://doi.org/10.3892/or.2018.6299
MLA
Nuvoli, S., Galassi, S., Gelo, I., Rocchitta, G., Fancellu, A., Serra, P. A., Madeddu, G., Spanu, A."The role of molecular breast imaging in predicting complete tumor response to treatment and residual tumor extent following neoadjuvant therapy". Oncology Reports 39.5 (2018): 2055-2062.
Chicago
Nuvoli, S., Galassi, S., Gelo, I., Rocchitta, G., Fancellu, A., Serra, P. A., Madeddu, G., Spanu, A."The role of molecular breast imaging in predicting complete tumor response to treatment and residual tumor extent following neoadjuvant therapy". Oncology Reports 39, no. 5 (2018): 2055-2062. https://doi.org/10.3892/or.2018.6299