caa a22 4500 445339322 CHVBK 20180317142806.0 cr unu---uuuuu 170323e20111001xx s 000 0 eng 10.1245/s10434-011-1919-5 doi (NATIONALLICENCE)springer-10.1245/s10434-011-1919-5 Accuracy of Clinical Examination, Digital Mammogram, Ultrasound, and MRI in Determining Postneoadjuvant Pathologic Tumor Response in Operable Breast Cancer Patients [Elektronische Daten] [Randal Croshaw, Hilary Shapiro-Wright, Erik Svensson, Kathleen Erb, Thomas Julian] Background: To determine the accuracy, positive predictive value (PPV), and negative predictive value (NPV) of clinical examination and breast imaging techniques in determining pathologic complete response in patients with locally advanced breast cancer after neoadjuvant therapy. Methods: A retrospective review was performed of data collected from patients treated with either neoadjuvant hormonal or chemotherapy between January 2005 and September 2010. Patients were evaluated by one of three surgical breast oncologists before neoadjuvant therapy and within 1month before surgery by clinical breast examination (CBE), digital mammogram, breast ultrasound, and/or magnetic resonance imaging (MRI). The accuracy, NPV, and PPV of each modality was calculated on the basis of the final pathologic report. Available data from the literature was synthesized. Results: Sixty-two tumors in 61 patients with a mean age of 56 (range 34-87) years were evaluated. Overall accuracy ranged from 54% (CBE) to 80% (breast ultrasound). All modalities had a PPV greater than 75% for identifying the presence of residual disease. The PPV of each modality was generally higher in the younger patients. The NPV of all methods was less than 50%. The accuracy and NPV were compromised even further in younger patients. The combination of our own data with data available from the literature revealed MRI to be superior with regard to accuracy and PPV, but the NPV of MRIs remained poor at 65%. Conclusions: All measured tests are good at predicting the presence of disease on final pathology, but none are able to reliably predict a pathologic complete response. Society of Surgical Oncology, 2011 Croshaw Randal Department of Human Oncology, Division of Breast Surgical Oncology, Allegheny General Hospital, Pittsburgh, USA aut Shapiro-Wright Hilary St. Clare Hospital, SSM Healthcare, Fenton, USA aut Svensson Erik Department of General Surgery, Allegheny General Hospital, Pittsburgh, USA aut Erb Kathleen Department of Human Oncology, Division of Breast Surgical Oncology, Allegheny General Hospital, Pittsburgh, USA aut Julian Thomas Department of Human Oncology, Division of Breast Surgical Oncology, Allegheny General Hospital, Pittsburgh, USA aut Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3160-3163 1068-9265 18:11<3160 2011 18 10434 https://doi.org/10.1245/s10434-011-1919-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-011-1919-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Croshaw Randal Department of Human Oncology, Division of Breast Surgical Oncology, Allegheny General Hospital, Pittsburgh, USA aut NATIONALLICENCE 700 1- Shapiro-Wright Hilary St. Clare Hospital, SSM Healthcare, Fenton, USA aut NATIONALLICENCE 700 1- Svensson Erik Department of General Surgery, Allegheny General Hospital, Pittsburgh, USA aut NATIONALLICENCE 700 1- Erb Kathleen Department of Human Oncology, Division of Breast Surgical Oncology, Allegheny General Hospital, Pittsburgh, USA aut NATIONALLICENCE 700 1- Julian Thomas Department of Human Oncology, Division of Breast Surgical Oncology, Allegheny General Hospital, Pittsburgh, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/11(2011-10-01), 3160-3163 1068-9265 18:11<3160 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer