Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy
Background: Prediction of tumor shrinkage and pattern of treatment response following neoadjuvant endocrine therapy (NET) for estrogen receptor positive (ER+), Her2 negative (Her2–) breast cancers have had limited assessment. We examined if ultrasound (US) and Ki–67 could predict the pathologic resp...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/11/3/417 |
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| author | Sean C. Liebscher Lyndsey J. Kilgore Onalisa Winblad Nika Gloyeske Kelsey Larson Christa Balanoff Lauren Nye Anne O’Dea Priyanka Sharma Bruce Kimler Qamar Khan Jamie Wagner |
| author_facet | Sean C. Liebscher Lyndsey J. Kilgore Onalisa Winblad Nika Gloyeske Kelsey Larson Christa Balanoff Lauren Nye Anne O’Dea Priyanka Sharma Bruce Kimler Qamar Khan Jamie Wagner |
| author_sort | Sean C. Liebscher |
| collection | DOAJ |
| description | Background: Prediction of tumor shrinkage and pattern of treatment response following neoadjuvant endocrine therapy (NET) for estrogen receptor positive (ER+), Her2 negative (Her2–) breast cancers have had limited assessment. We examined if ultrasound (US) and Ki–67 could predict the pathologic response to treatment with NET and how the pattern of response may impact surgical planning. Methods: A total of 103 postmenopausal women with ER+, HER2– breast cancer enrolled on the FELINE trial had Ki–67 obtained at baseline, day 14, and surgical pathology. A total of 70 patients had an US at baseline and at the end of treatment (EOT). A total of 48 patients had residual tumor bed cellularity (RTBC) assessed. The US response was defined as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). CR or PR on imaging and ≤70% residual tumor bed cellularity (RTBC) defined a contracted response pattern. Results: A decrease in Ki–67 at day 14 was not predictive of EOT US response or RTBC. A contracted response pattern was identified in one patient with CR and in sixteen patients (33%) with PR on US. Although 26 patients (54%) had SD on imaging, 22 (85%) had RTBC ≤70%, suggesting a non-contracted response pattern of the tumor bed. The remaining four (15%) with SD and five with PD had no response. Conclusion: Ki–67 does not predict a change in tumor size or RTBC. NET does not uniformly result in a contracted response pattern of the tumor bed. Caution should be taken when using NET for the purpose of downstaging tumor size or converting borderline mastectomy/lumpectomy patients. |
| first_indexed | 2024-03-11T09:44:00Z |
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| id | doaj.art-7f31184df1614bdab9182b0c67313859 |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-11T09:44:00Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-7f31184df1614bdab9182b0c673138592023-11-16T16:45:04ZengMDPI AGHealthcare2227-90322023-02-0111341710.3390/healthcare11030417Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine TherapySean C. Liebscher0Lyndsey J. Kilgore1Onalisa Winblad2Nika Gloyeske3Kelsey Larson4Christa Balanoff5Lauren Nye6Anne O’Dea7Priyanka Sharma8Bruce Kimler9Qamar Khan10Jamie Wagner11Department of Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Radiology, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Radiation Oncology, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Internal Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USADepartment of Surgery, University of Kansas Medical Center, Kansas City, KS 66160, USABackground: Prediction of tumor shrinkage and pattern of treatment response following neoadjuvant endocrine therapy (NET) for estrogen receptor positive (ER+), Her2 negative (Her2–) breast cancers have had limited assessment. We examined if ultrasound (US) and Ki–67 could predict the pathologic response to treatment with NET and how the pattern of response may impact surgical planning. Methods: A total of 103 postmenopausal women with ER+, HER2– breast cancer enrolled on the FELINE trial had Ki–67 obtained at baseline, day 14, and surgical pathology. A total of 70 patients had an US at baseline and at the end of treatment (EOT). A total of 48 patients had residual tumor bed cellularity (RTBC) assessed. The US response was defined as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD). CR or PR on imaging and ≤70% residual tumor bed cellularity (RTBC) defined a contracted response pattern. Results: A decrease in Ki–67 at day 14 was not predictive of EOT US response or RTBC. A contracted response pattern was identified in one patient with CR and in sixteen patients (33%) with PR on US. Although 26 patients (54%) had SD on imaging, 22 (85%) had RTBC ≤70%, suggesting a non-contracted response pattern of the tumor bed. The remaining four (15%) with SD and five with PD had no response. Conclusion: Ki–67 does not predict a change in tumor size or RTBC. NET does not uniformly result in a contracted response pattern of the tumor bed. Caution should be taken when using NET for the purpose of downstaging tumor size or converting borderline mastectomy/lumpectomy patients.https://www.mdpi.com/2227-9032/11/3/417breast cancerneoadjuvant endocrine therapyresponse to treatment |
| spellingShingle | Sean C. Liebscher Lyndsey J. Kilgore Onalisa Winblad Nika Gloyeske Kelsey Larson Christa Balanoff Lauren Nye Anne O’Dea Priyanka Sharma Bruce Kimler Qamar Khan Jamie Wagner Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy Healthcare breast cancer neoadjuvant endocrine therapy response to treatment |
| title | Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy |
| title_full | Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy |
| title_fullStr | Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy |
| title_full_unstemmed | Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy |
| title_short | Use of Ultrasound and Ki–67 Proliferation Index to Predict Breast Cancer Tumor Response to Neoadjuvant Endocrine Therapy |
| title_sort | use of ultrasound and ki 67 proliferation index to predict breast cancer tumor response to neoadjuvant endocrine therapy |
| topic | breast cancer neoadjuvant endocrine therapy response to treatment |
| url | https://www.mdpi.com/2227-9032/11/3/417 |
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