Abstract 2632
Background
Dedicated breast positron emission tomography (DbPET) with 18F-fluorodeoxyglucose (FDG) can detect intratumoral heterogeneity. In a previous study, we proved that intratumoral heterogeneous distribution of FDG on DbPET is significantly related to a high nuclear grade and high Ki-67 proliferation index; we also proved that DbPET is useful for predicting residual breast tumors after neoadjuvant chemotherapy (NAC). This study included patients with breast cancer who exhibited a ring-like uptake without central FDG accumulation on DbPET and aimed to evaluate whether the uptake can predict the effects of NAC in patients with breast cancer.
Methods
The study included 83 consecutive patients with breast cancer who subsequently underwent DbPET and NAC between August 2016 and March 2019 and evaluated the relationship between pathological response to NAC and clinicopathologic factors (clinical T1: n = 14; clinical N0: n = 33; nuclear grade 1 or 2: n = 22; Ki67 ≥ 20: n = 78; ER positive: n = 52; and HER-2 positive: n = 32), such as intratumoral heterogeneous distribution of FDG (positive: n = 54) and ring-like uptake without central FDG accumulation (positive: n = 11) on DbPET images.
Results
Surgical pathological findings obtained after the NAC indicated pathological complete response (pCR) and non-pCR in 32 (38.6%) and 51 (61.4%) patients, respectively. For all the patients, significant predictors for pCR were identified in univariate analyses (clinical T: odds ratio = 3.60, p = 0.03; clinical N: odds ratio = 2.48, p = 0.049; HER-2 overexpression: odds ratio = 2.72, p = 0.03; and ring-like uptake: odds ratio = 5.33, p = 0.01) and multivariate analyses (HER-2 overexpression: odds ratio = 3.29, p = 0.03; ring-like uptake: odds ratio = 17.6, p = 0.0006) (Table).Table:
279P Univariate and multivariate logistic analysis of significant predictive clinicopathological factors for pCR
Characteristic | Univariate logistic analysis | Multivariate logistic analysis | ||||
---|---|---|---|---|---|---|
OR | 95%CI | p | OR | 95%CI | p | |
Age, <50 v ≥ 50 | 1.38 | 0.57-3.38 | 0.48 | 1.97 | 0.65-5.98 | 0.23 |
Clinical T, T1 v T2- T4 | 3.60 | 1.11-12.9 | 0.03 | 3.86 | 0.97-15.4 | 0.06 |
Clinical N, Negative v Positive | 2.48 | 1.00-6.28 | 0.049 | 2.86 | 0.97-8.42 | 0.06 |
Nuclear Grade, 3 v 1-2 | 1.49 | 0.54-4.38 | 0.45 | 1.65 | 0.41-6.70 | 0.48 |
Ki67, ≥20 v < 20 | 2.64 | 0.37-52.8 | 0.36 | 1.34 | 0.11-16.5 | 0.82 |
ER, Negative v Positive | 1.25 | 0.50-3.12 | 0.63 | 1.05 | 0.33-3.34 | 0.93 |
HER-2, Positive v Negative | 2.72 | 1.09-6.94 | 0.03 | 3.29 | 1.11-9.73 | 0.03 |
Intratumoral heterogenity, Positive v Negative | 1.50 | 0.59-3.78 | 0.39 | 1.69 | 0.43-6.57 | 0.45 |
Ring-like uptake, Positive v Negative | 5.33 | 1.40-26.1 | 0.01 | 17.6 | 2.27-136.2 | 0.006 |
Conclusions
Ring-like uptake on DbPET provides predictive value for evaluating pCR to NAC in patients with breast cancer and might inform therapeutic decisions.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
5812 - Correlation between the density of tumor-infiltrating lymphocytes, immune cell subsets in tumor stroma and response to systemic therapy in breast cancer
Presenter: Cvetka Grasic Kuhar
Session: Poster Display session 2
Resources:
Abstract
4734 - BRCA1/2 Testing in HER2- Advanced Breast Cancer (ABC): Results from the European Component of a Multi-Country Real World Study
Presenter: Michael Patrick Lux
Session: Poster Display session 2
Resources:
Abstract
1686 - In vitro and in vivo rescue of resistance to BET inhibitors by targeting PLK1 in triple negative breast cancer.
Presenter: Cristina Nieto-jiménez
Session: Poster Display session 2
Resources:
Abstract
5020 - Neoadjuvant endocrine therapy in combination with melatonin and metformin in locally advanced breast cancer
Presenter: Tatiana Semiglazova
Session: Poster Display session 2
Resources:
Abstract
5082 - Melatonin and metformin in neoadjuvant chemotherapy in locally advanced breast cancer
Presenter: Tatiana Semiglazova
Session: Poster Display session 2
Resources:
Abstract
2642 - Patient-tailored tamoxifen dosing based on an increased quantitative understanding of its complex pharmacokinetics: A novel integrative modelling approach
Presenter: Anna Mueller-Schoell
Session: Poster Display session 2
Resources:
Abstract
2461 - Lack of benefit of neoadjuvant pertuzumab in high risk HER2 positive breast cancer. A retrospective case-control study of 355 cases with biomarker analysis.
Presenter: Manuela Tiako Meyo
Session: Poster Display session 2
Resources:
Abstract
4776 - Targeting CDCA3 to improve chemotherapy response in triple-negative breast cancer patients
Presenter: Kenneth O'Byrne
Session: Poster Display session 2
Resources:
Abstract
1674 - Activity of BET-proteolysis targeting chimeric (PROTAC) compounds in triple negative breast cancer
Presenter: María Del Mar Noblejas López
Session: Poster Display session 2
Resources:
Abstract
5629 - Outcome of triple negative inflammatory breast cancers (TNIBC) treated with dose dense neoadjuvant epirubicin cyclophosphmide, prognostic impact of pre and post neoadjuvant chemotherapy (NAC) tumor infiltrating lymphocytes (TIL) and post NAC lymphovascular invasion
Presenter: Luca Campedel
Session: Poster Display session 2
Resources:
Abstract