TY - JOUR
T1 - Disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and molecular subtype
T2 - prediction of axillary treatment response after neoadjuvant systemic therapy for breast cancer
AU - the REFINE Study Group
AU - van Amstel, Florien J.G.
AU - de Mooij, Cornelis M.
AU - Simons, Janine M.
AU - Mitea, Cristina
AU - van Diest, Paul J.
AU - Nelemans, Patty J.
AU - van der Pol, Carmen C.
AU - Luiten, Ernest J.T.
AU - Koppert, Linetta B.
AU - Smidt, Marjolein L.
AU - van Nijnatten, Thiemo J.A.
AU - Verhoef, Kees
AU - Jager, Agnes
AU - de Monyé, Cécile
AU - van Klaveren, D.
N1 - Publisher Copyright: © The Author(s) 2024. Published by Oxford University Press on behalf of BJS Foundation Ltd.
PY - 2024/9
Y1 - 2024/9
N2 - Background: Axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT combined with pathological axillary treatment response has been proposed to guide de-escalation of axillary treatment for clinically node-positive breast cancer patients treated with neoadjuvant systemic therapy. The aim of this study was to assess whether axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and breast cancer molecular subtype are predictors of axillary pCR. Methods: This study included clinically node-positive patients treated with neoadjuvant systemic therapy in the prospective Radioactive Iodine Seed placement in the Axilla with Sentinel lymph node biopsy (‘RISAS’) trial (NCT02800317) with baseline [18F] fluorodeoxyglucose PET/CT imaging available. The predictive value of axillary disease extent according to baseline [18F] fluorodeoxyglucose PET/CT and breast cancer molecular subtype to estimate axillary pCR was evaluated using logistic regression analysis. Discriminative ability is expressed using ORs with 95% confidence intervals. Results: Overall, 185 patients were included, with an axillary pCR rate of 29.7%. The axillary pCR rate for patients with limited versus advanced baseline axillary disease according to [18F]fluorodeoxyglucose PET/CT was 31.9% versus 26.1% respectively. Axillary disease extent was not a significant predictor of axillary pCR. There were significant differences in axillary pCR rates between breast cancer molecular subtypes. The lowest probability (7%) was found for hormone receptor+/human epidermal growth factor receptor 2− tumours. Using this category as a reference group, significantly increased ORs of 14.82 for hormone receptor+/human epidermal growth factor receptor 2+ tumours, 40 for hormone receptor−/human epidermal growth factor receptor 2+ tumours, and 6.91 for triple-negative tumours were found. Conclusion: Molecular subtype is a significant predictor of axillary pCR after neoadjuvant systemic therapy, whereas axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT is not.
AB - Background: Axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT combined with pathological axillary treatment response has been proposed to guide de-escalation of axillary treatment for clinically node-positive breast cancer patients treated with neoadjuvant systemic therapy. The aim of this study was to assess whether axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT and breast cancer molecular subtype are predictors of axillary pCR. Methods: This study included clinically node-positive patients treated with neoadjuvant systemic therapy in the prospective Radioactive Iodine Seed placement in the Axilla with Sentinel lymph node biopsy (‘RISAS’) trial (NCT02800317) with baseline [18F] fluorodeoxyglucose PET/CT imaging available. The predictive value of axillary disease extent according to baseline [18F] fluorodeoxyglucose PET/CT and breast cancer molecular subtype to estimate axillary pCR was evaluated using logistic regression analysis. Discriminative ability is expressed using ORs with 95% confidence intervals. Results: Overall, 185 patients were included, with an axillary pCR rate of 29.7%. The axillary pCR rate for patients with limited versus advanced baseline axillary disease according to [18F]fluorodeoxyglucose PET/CT was 31.9% versus 26.1% respectively. Axillary disease extent was not a significant predictor of axillary pCR. There were significant differences in axillary pCR rates between breast cancer molecular subtypes. The lowest probability (7%) was found for hormone receptor+/human epidermal growth factor receptor 2− tumours. Using this category as a reference group, significantly increased ORs of 14.82 for hormone receptor+/human epidermal growth factor receptor 2+ tumours, 40 for hormone receptor−/human epidermal growth factor receptor 2+ tumours, and 6.91 for triple-negative tumours were found. Conclusion: Molecular subtype is a significant predictor of axillary pCR after neoadjuvant systemic therapy, whereas axillary disease extent according to baseline [18F]fluorodeoxyglucose PET/CT is not.
UR - https://www.scopus.com/pages/publications/85205451613
U2 - 10.1093/bjs/znae203
DO - 10.1093/bjs/znae203
M3 - Article
C2 - 39302345
AN - SCOPUS:85205451613
SN - 0007-1323
VL - 111
JO - British Journal of Surgery
JF - British Journal of Surgery
IS - 9
M1 - znae203
ER -
