Breast Cancer Research (Mar 2021)

Magnetic resonance imaging and ultrasound for prediction of residual tumor size in early breast cancer within the ADAPT subtrials

  • Monika Graeser,
  • Simone Schrading,
  • Oleg Gluz,
  • Kevin Strobel,
  • Christopher Herzog,
  • Lale Umutlu,
  • Alex Frydrychowicz,
  • Dorothea Rjosk-Dendorfer,
  • Rachel Würstlein,
  • Ralph Culemann,
  • Christine Eulenburg,
  • Jascha Adams,
  • Henrik Nitzsche,
  • Anna Prange,
  • Sherko Kümmel,
  • Eva-Maria Grischke,
  • Helmut Forstbauer,
  • Michael Braun,
  • Jochem Potenberg,
  • Raquel von Schumann,
  • Bahriye Aktas,
  • Cornelia Kolberg-Liedtke,
  • Nadia Harbeck,
  • Christiane K. Kuhl,
  • Ulrike Nitz

DOI
https://doi.org/10.1186/s13058-021-01413-y
Journal volume & issue
Vol. 23, no. 1
pp. 1 – 13

Abstract

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Abstract Background Prediction of histological tumor size by post-neoadjuvant therapy (NAT) ultrasound and magnetic resonance imaging (MRI) was evaluated in different breast cancer subtypes. Methods Imaging was performed after 12-week NAT in patients enrolled into three neoadjuvant WSG ADAPT subtrials. Imaging performance was analyzed for prediction of residual tumor measuring ≤10 mm and summarized using positive (PPV) and negative (NPV) predictive values. Results A total of 248 and 588 patients had MRI and ultrasound, respectively. Tumor size was over- or underestimated by 10 mm) was 0.52 and 0.61. MRI demonstrated a higher NPV and lower PPV than ultrasound in hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-positive and in HR−/HER2+ tumors. Both methods had a comparable NPV and PPV in HR−/HER2− tumors. Conclusions In HR+/HER2+ and HR−/HER2+ breast cancer, MRI is less likely than ultrasound to underestimate while ultrasound is associated with a lower risk to overestimate tumor size. These findings may help to select the most optimal imaging approach for planning surgery after NAT. Trial registration Clinicaltrials.gov , NCT01815242 (registered on March 21, 2013), NCT01817452 (registered on March 25, 2013), and NCT01779206 (registered on January 30, 2013).

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