Breast Neoplasms Clinical Trial
Official title:
Can a Pathological Complete Response in the Breast be Diagnosed by Vacuum-assisted, Ultrasound Guided Minimal Invasive Biopsy After Neoadjuvant Chemotherapy in Breast Cancer Patients? A Proof of Concept From a Prospective Cohort Study
The study aims to evaluate the ability of representative vacuum-assisted minimal invasive biopsy (VAB) to diagnose pathological complete response (pCR=ypT0) in breast cancer patients after neoadjuvant chemotherapy (NACT).
Neoadjuvant chemotherapy (NACT) is an increasingly used approach for patients with locally
advanced and primarily inoperable breast cancer or for patients with potentially
chemosensitive tumors. In clinical routine surgical treatment follows the pre-operative
chemotherapy. However, recent studies have demonstrated that shrinking tumors need less
surgical treatment indicating that patients with pCR could potentially be spared of surgery
in the future.
Up to now, prediction of pCR after NACT, i.e. diagnosing a pCR without surgery, is based on
tumor biology at diagnosis, the applied NACT regimen and breast imaging results; all with
mediocre accuracy. This prospective, monocenter diagnostic trial aims to explore if minimal
invasive biopsies (MIB) might overcome this diagnostic challenge.
From September 1st, 2014 to February 15th, 2015 the investigators performed ultrasound guided
vacuum-assisted minimal invasive biopsy (VAB) on 50 breast cancer patients after NACT and
directly prior to surgery. To analyse VAB pathologically results were categorized as follows:
residual vital tumor cells (invasive, in situ, both, lymphangiosis carcinomatosous) present,
(significant parts of) the tumor bed present, neither vital tumor cells nor (significant
parts of) the tumor bed (indicating a non representative VAB). The results were compared to
those of the pathological examination of surgical specimen.
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