Role of the radiologist during neoadjuvant systemic therapy for breast cancer

Česká verzia

Authors: D. Houserková ^1,2; N. Zlámalová ³; K. Spáčilová ^1,2; K. Vomáčková ³; B. Donociková ⁴; M. Kolečková ⁵; E. Buriánková ^1,6
Authors place of work: MAMMACENTRUM Olomouc, screeningové mamodiagnostické centrum ¹; Magnetická rezonance Medihope Olomouc ²; Chirurgická klinika Fakultní nemocnice Olomouc ³; Onkologická klinika Fakultní nemocnice Olomouc ⁴; Ústav klinické a molekulární patologie Fakultní nemocnice Olomouc ⁵; Klinika nukleární medicíny Fakultní nemocnice Olomouc ⁶
Published in the journal: Rozhl. Chir., 2021, roč. 100, č. 6, s. 285-294.
Category: Case Report
doi: https://doi.org/10.33699/PIS.2021.100.6.285–294

Summary

Introduction: Neoadjuvant therapy (NT) is one of the possible oncological treatment strategies for breast cancer. Its aim is to achieve down-staging of the tumour in the breast and axilla and thus the possibility of converting mastectomy to a breast-conserving procedure, and also to allow for a less burdensome and more targeted operation of the axillary lymph nodes. The role of the radiologist is to utilise imaging procedures for precise local staging of the malignancy prior to NT, to evaluate the effect of treatment during its course and upon its completion, and to perform restaging of the cancer in the breast and axilla.

Case reports: The authors present three case reports of female patients with breast cancer who underwent neoadjuvant chemotherapy (NCT). They describe the diagnostic procedure and imaging methods used to establish local staging of the cancer prior to treatment, to monitor the disease during the course of treatment, and to perform restaging of the cancer after completing NCT. The radiological response after NCT completion was correlated with the pathological response.

Conclusion: Correct determination of the extent of the cancer in the breast and axilla by the radiologist before NT and precise histological analysis of the tumour by the pathologist are fundamental for selecting the appropriate treatment for patients at the multidisciplinary breast tumour board.

Keywords:

breast cancer − neoadjuvant therapy – Mammography – ultrasound − magnetic resonance imaging

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