PCR COMPLETE RESPONSE SERIES

Neither ultrasound nor mammography is reliable with false negative rates (FNR) ranging from 9 to 70% ( 12– 14). Some studies focus on the accuracy and reliability of non-invasive imaging methods to predict breast pCR, but the results are far from satisfactory. From this point of view, it is of great clinical significance to explore a less invasive method to predict breast pCR after NST. For patients with no residual cancer in the breast (breast pCR), it is reasonable to consider an omission of breast surgery ( 10, 11).

PCR COMPLETE RESPONSE SERIES

As one of the main options of breast surgery, breast-conserving surgery after NST is universally performed, the oncologic safety of which has been confirmed by a series of studies ( 8, 9). Currently, the standard diagnostic approach for pCR of the breast is breast surgery and pathologic examination of the specimen. For triple-negative (TN) and human epidermal growth factor receptor 2-positive (HER2+) subtypes, pCR rates of up to 60–70% can be achieved with the administration of carboplatin regimens and dual HER2 blockage ( 4, 5).Īchievement of pCR after NST is associated with less recurrence and favorable survival of breast cancer, and recent studies show that escalation of adjuvant systemic therapy could have additional benefits for patients with residual disease (non-pCR) ( 2, 3, 6, 7). In recent years, with the improvement of neoadjuvant chemotherapy and targeted therapy, the pCR rates of breast cancer have increased dramatically. Pathologic complete response (pCR) is an ideal response to NST, indicating the absence of residual cancer in a surgical specimen although it has different definitions ( 2, 3). Neoadjuvant systemic therapy (NST) is used in approximately 30% of patients with early stage breast cancer before definitive surgery ( 1). It is of utmost clinical importance to standardize the MIB procedure and incorporate other factors into the evaluation in order to improve the accuracy to an acceptable level. Subgroup analyses and meta-regressions implied that trials with responses not limited to clinical complete response (cCR) had a significantly higher accuracy of MIB than those with only cCR (RDOR: 7.65 95% CI: 1.05–55.46 P = 0.046).Ĭonclusion: Current image-guided MIB methods are not accurate enough in terms of predicting breast pCR after NST. By combining relevant data, there were no significant differences in sensitivity or specificity among different molecular subtypes of breast cancer ( P > 0.05). The pooled sensitivity and specificity of MIB were 0.72 and 0.99 (95% CI: 0.89–1.00), respectively. Results: Nine trials (with 1,030 breast cancer patients) were included in this meta-analysis. Subgroup analyses and meta-regressions were also performed to investigate potential causes of heterogeneity. We extracted relevant data and constructed a 2 × 2 contingency table to analyze the predictive accuracy of MIB for breast pCR. The Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) tool was used to evaluate the quality of included trials.

Materials and Methods: We identified relevant research reports in online databases through February 2020. This study conducted a meta-analysis to evaluate the diagnostic accuracy of MIB. In recent years, several trials investigated the predictive value of image-guided minimally invasive biopsy (MIB) for breast pCR after NST. The standard diagnostic approach for pathologic complete response (pCR) of the breast is breast surgery and pathologic examination. Department of Breast Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, Chinaīackground: Neoadjuvant systemic therapy (NST) is commonly used in patients with early stage breast cancer before definitive surgery.Yan Li, Yidong Zhou, Feng Mao, Yan Lin, Xiaohui Zhang, Songjie Shen and Qiang Sun *

Pcr complete response