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Portrait of Daniel Förnvik. Photo

Daniel Förnvik

Associate professor

Portrait of Daniel Förnvik. Photo

Mammographic density is a potential predictive marker of pathological response after neoadjuvant chemotherapy in breast cancer

Author

  • Ida Skarping
  • Daniel Förnvik
  • Hanna Sartor
  • Uffe Heide-Jørgensen
  • Sophia Zackrisson
  • Signe Borgquist

Summary, in English

BACKGROUND: Our aim is to study if mammographic density (MD) prior to neoadjuvant chemotherapy is a predictive factor in accomplishing a pathological complete response (pCR) in neoadjuvant-treated breast cancer patients.

METHODS: Data on all neoadjuvant treated breast cancer patients in Southern Sweden (2005-2016) were retrospectively identified, with patient and tumor characteristics retrieved from their medical charts. Diagnostic mammograms were used to evaluate and score MD as categorized by breast composition with the Breast Imaging-Reporting and Data System (BI-RADS) 5th edition. Logistic regression was used in complete cases to assess the odds ratios (OR) for pCR compared to BI-RADS categories (a vs b-d), adjusting for patient and pre-treatment tumor characteristics.

RESULTS: A total of 302 patients were included in the study population, of which 57 (18.9%) patients accomplished pCR following neoadjuvant chemotherapy. The number of patients in the BI-RADS category a, b, c, and d were separately 16, 120, 140, and 26, respectively. In comparison to patients with BI-RADS breast composition a, patients with denser breasts had a lower OR of accomplishing pCR: BI-RADS b 0.32 (95%CI 0.07-0.1.5), BI-RADS c 0.30 (95%CI 0.06-1.45), and BI-RADS d 0.06 (95%CI 0.01-0.56). These associations were measured with lower point estimates, but wider confidence interval, in premenopausal patients; OR of accomplishing pCR for BI-RADS d in comparison to BI-RADS a: 0.03 (95%CI 0.00-0.76).

CONCLUSIONS: The likelihood of accomplishing pCR is indicated to be lower in breast cancer patients with higher MD, which need to be analysed in future studies for improved clinical decision-making regarding neoadjuvant treatment.

Department/s

  • Breastcancer
  • Breast cancer prevention & intervention
  • BioCARE: Biomarkers in Cancer Medicine improving Health Care, Education and Innovation
  • Medical Radiation Physics, Malmö
  • Radiology Diagnostics, Malmö

Publishing year

2019-12-30

Language

English

Pages

1272-1272

Publication/Series

BMC Cancer

Volume

19

Issue

1

Document type

Journal article

Publisher

BioMed Central (BMC)

Topic

  • Cancer and Oncology

Keywords

  • Adult
  • Aged
  • Breast/diagnostic imaging
  • Breast Density
  • Breast Neoplasms/diagnosis
  • Clinical Decision-Making
  • Female
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy
  • Predictive Value of Tests
  • Prognosis
  • Retrospective Studies
  • Sweden
  • Treatment Outcome

Status

Published

Research group

  • Breast cancer prevention & intervention
  • Medical Radiation Physics, Malmö
  • Radiology Diagnostics, Malmö

ISBN/ISSN/Other

  • ISSN: 1471-2407