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Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy

Background: Prediction of tumor shrinkage and pattern of treatment response following neoadjuvant endocrine therapy (NET) for estrogen receptor positive (ER+), Her2 negative (Her2–) breast cancers have had limited assessment. We examined if ultrasound (US) and Ki–67 could predict the pathologic resp...

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Autores principales: Liebscher, Sean C., Kilgore, Lyndsey J., Winblad, Onalisa, Gloyeske, Nika, Larson, Kelsey, Balanoff, Christa, Nye, Lauren, O’Dea, Anne, Sharma, Priyanka, Kimler, Bruce, Khan, Qamar, Wagner, Jamie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913996/
https://www.ncbi.nlm.nih.gov/pubmed/36766992
http://dx.doi.org/10.3390/healthcare11030417
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author Liebscher, Sean C.
Kilgore, Lyndsey J.
Winblad, Onalisa
Gloyeske, Nika
Larson, Kelsey
Balanoff, Christa
Nye, Lauren
O’Dea, Anne
Sharma, Priyanka
Kimler, Bruce
Khan, Qamar
Wagner, Jamie
author_facet Liebscher, Sean C.
Kilgore, Lyndsey J.
Winblad, Onalisa
Gloyeske, Nika
Larson, Kelsey
Balanoff, Christa
Nye, Lauren
O’Dea, Anne
Sharma, Priyanka
Kimler, Bruce
Khan, Qamar
Wagner, Jamie
author_sort Liebscher, Sean C.
collection PubMed
description Background: Prediction of tumor shrinkage and pattern of treatment response following neoadjuvant endocrine therapy (NET) for estrogen receptor positive (ER+), Her2 negative (Her2–) breast cancers have had limited assessment. We examined if ultrasound (US) and Ki–67 could predict the pathologic response to treatment with NET and how the pattern of response may impact surgical planning. Methods: A total of 103 postmenopausal women with ER+, HER2– breast cancer enrolled on the FELINE trial had Ki–67 obtained at baseline, day 14, and surgical pathology. A total of 70 patients had an US at baseline and at the end of treatment (EOT). A total of 48 patients had residual tumor bed cellularity (RTBC) assessed. The US response was defined as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). CR or PR on imaging and ≤70% residual tumor bed cellularity (RTBC) defined a contracted response pattern. Results: A decrease in Ki–67 at day 14 was not predictive of EOT US response or RTBC. A contracted response pattern was identified in one patient with CR and in sixteen patients (33%) with PR on US. Although 26 patients (54%) had SD on imaging, 22 (85%) had RTBC ≤70%, suggesting a non-contracted response pattern of the tumor bed. The remaining four (15%) with SD and five with PD had no response. Conclusion: Ki–67 does not predict a change in tumor size or RTBC. NET does not uniformly result in a contracted response pattern of the tumor bed. Caution should be taken when using NET for the purpose of downstaging tumor size or converting borderline mastectomy/lumpectomy patients.
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spelling pubmed-99139962023-02-11 Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy Liebscher, Sean C. Kilgore, Lyndsey J. Winblad, Onalisa Gloyeske, Nika Larson, Kelsey Balanoff, Christa Nye, Lauren O’Dea, Anne Sharma, Priyanka Kimler, Bruce Khan, Qamar Wagner, Jamie Healthcare (Basel) Article Background: Prediction of tumor shrinkage and pattern of treatment response following neoadjuvant endocrine therapy (NET) for estrogen receptor positive (ER+), Her2 negative (Her2–) breast cancers have had limited assessment. We examined if ultrasound (US) and Ki–67 could predict the pathologic response to treatment with NET and how the pattern of response may impact surgical planning. Methods: A total of 103 postmenopausal women with ER+, HER2– breast cancer enrolled on the FELINE trial had Ki–67 obtained at baseline, day 14, and surgical pathology. A total of 70 patients had an US at baseline and at the end of treatment (EOT). A total of 48 patients had residual tumor bed cellularity (RTBC) assessed. The US response was defined as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). CR or PR on imaging and ≤70% residual tumor bed cellularity (RTBC) defined a contracted response pattern. Results: A decrease in Ki–67 at day 14 was not predictive of EOT US response or RTBC. A contracted response pattern was identified in one patient with CR and in sixteen patients (33%) with PR on US. Although 26 patients (54%) had SD on imaging, 22 (85%) had RTBC ≤70%, suggesting a non-contracted response pattern of the tumor bed. The remaining four (15%) with SD and five with PD had no response. Conclusion: Ki–67 does not predict a change in tumor size or RTBC. NET does not uniformly result in a contracted response pattern of the tumor bed. Caution should be taken when using NET for the purpose of downstaging tumor size or converting borderline mastectomy/lumpectomy patients. MDPI 2023-02-01 /pmc/articles/PMC9913996/ /pubmed/36766992 http://dx.doi.org/10.3390/healthcare11030417 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Liebscher, Sean C.
Kilgore, Lyndsey J.
Winblad, Onalisa
Gloyeske, Nika
Larson, Kelsey
Balanoff, Christa
Nye, Lauren
O’Dea, Anne
Sharma, Priyanka
Kimler, Bruce
Khan, Qamar
Wagner, Jamie
Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy
title Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy
title_full Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy
title_fullStr Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy
title_full_unstemmed Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy
title_short Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy
title_sort use of ultrasound and ki–67 proliferation index to predict breast cancer tumor response to neoadjuvant endocrine therapy
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9913996/
https://www.ncbi.nlm.nih.gov/pubmed/36766992
http://dx.doi.org/10.3390/healthcare11030417
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