Utility of 18 F-FDG PET/CT for predicting pathologic complete response in hormone receptor-positive, HER2-negative breas
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RESEARCH ARTICLE
Open Access
Utility of 18F-FDG PET/CT for predicting pathologic complete response in hormone receptor-positive, HER2-negative breast cancer patients receiving neoadjuvant chemotherapy In Hee Lee1†, Soo Jung Lee2†, Jeeyeon Lee3, Jin Hyang Jung3, Ho Yong Park3, Shin Young Jeong4, Sang-woo Lee4 and Yee Soo Chae2*
Abstract Background: Pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) is a predictor of improved outcomes in breast cancer. In patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2) -negative breast cancer, the response to NAC is variable and mostly limited. This study was an investigation of the predictive relevance of parameters of 18F-FDG PET/CT for the pCR to NAC in patients with HR-positive, HER2–negative breast cancer. Methods: AH total of 109 consecutive HR-positive and HER2-negative breast cancer patients who were treated with NAC were enrolled in this prospective cohort study. The relationships between pretreatment 18F-FDG PET/ CT and clinical outcomes including pathologic response to NAC were evaluated. Results: All patients finished their planned NAC cycles and eight patients (7.3%) achieved pCR. In the receiver operating characteristic (ROC) curve analysis, pSUVmax exhibited high sensitivity and specificity for predicting pCR. Furthermore, multivariate logistic regression analysis revealed pSUVmax as a predictive factor for pCR (hazard ratio = 17.452; 95% CI = 1.847–164.892; p = 0.013). Conclusion: The results of this study suggest that 18F-FDG PET/CT pSUVmax is a predictive factor for pCR of HR-positive, HER2-negative breast cancer to NAC. Keywords: Breast cancer, Neoadjuvant chemotherapy, Pathologic complete response, SUVmax
Background Despite remarkable improvement in breast cancer treatment, breast cancer is still one of the most prevalent cancers and the second leading cause of cancer death in women. Therefore, research on new treatment approaches, including neoadjuvant chemotherapy (NAC), is ongoing. NAC was initially introduced for the * Correspondence: [email protected] † In Hee Lee and Soo Jung Lee contributed equally to this work. 2 Department of Oncology/Hematology, Kyungpook National University Chilgok Hospital, Kyungpook National University, Daegu, South Korea Full list of author information is available at the end of the article
management of locally advanced or inoperable breast cancers and showed additional advantages, such as down-staging to breast conserving surgery [1–3] and monitoring therapeutic response [4], without significant survival outcomes [5, 6]. For resectable breast cancer, pathological parameters such as tumor size, axillary lymph node involvement, histological grade, hormone receptor (HR) status, and human epidermal growth factor receptor 2 (HER2) status have been used as prognostic factors for survival. Most of these pathological parameters cannot be fully evaluated from small
© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 Intern
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