摘要
Высокие показатели достижения полного патоморфологического ответа (pCR), наблюдаемые у пациентов с HER2-позитивным и трижды-негативным раком молочной железы, получавших современную системную терапию, стимулировали интерес к сокращению объема хирургического вмешательства с возможным последующим полным отказом от операции на молочной железе у этих пациентов, при условии, что pCR может быть точно определен с помощью лучевых диагностических методов визуализации, вакуум-ассистированной трепан-биопсии и корректной гистопатологической оценки трепан-ткани. В этой обзорной статье собраны имеющиеся данные касающиеся способов подтверждения полного патоморфологического ответа при помощи трепан- и вакуум-ассистированной биопсии после проведения неоадъювантной системной терапии.
参考
Heil J, Kuerer HM, Pfob A et al. Eliminating the breast cancer surgery paradigm after neoadjuvant systemic therapy: current evidence and future challenges // Ann Oncol. 2020;31(1):61–71. doi:10.1016/j.annonc.2019.10.012
Murphy BL, Day CN, Hoskin TL et al. Neoadjuvant Chemotherapy Use in Breast Cancer is Greatest in Excellent Responders: Triple-Negative and HER2+ Subtypes // Ann Surg Oncol. 2018;25(8):2241–2248. doi:10.1245/s10434-018-6531-5
Cortazar P, Zhang L, Untch M et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis // Lancet. 2014;384(9938):164–172. doi:10.1016/S0140-6736(13)62422-8
Symmans WF, Wei C, Gould R et al. Long-Term Prognostic Risk After Neoadjuvant Chemotherapy Associated With Residual Cancer Burden and Breast Cancer Subtype // J Clin Oncol. 2017;35(10):1049–1060. doi:10.1200/JCO.2015.63.1010
Haque W, Verma V, Hatch S et al. Response rates and pathologic complete response by breast cancer molecular subtype following neoadjuvant chemotherapy // Breast Cancer Res Treat. 2018;170(3):559–567. doi:10.1007/s10549-018-4801-3
Goorts B, van Nijnatten TJ, de Munck L et al. Clinical tumor stage is the most important predictor of pathological complete response rate after neoadjuvant chemotherapy in breast cancer patients // Breast Cancer Res Treat. 2017;163(1):83–91. doi:10.1007/s10549-017-4155-2
Semiglazov VF, Topuzov EE, Bavli JL et al. Primary (neoadjuvant) chemotherapy and radiotherapy compared with primary radiotherapy alone in stage IIb–IIIa breast cancer // Ann Oncol. 1994;5(7):591–595. doi:10.1093/oxfordjournals.annonc.a058929
Cortazar P, Semiglazov V et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis // The Lancet. 2014;384:9938:164–172
van Ramshorst MS, van der Voort A, van Werkhoven ED et al. Neoadjuvant chemotherapy with or without anthracyclines in the presence of dual HER2 blockade for HER2-positive breast cancer (TRAIN-2): a multicentre, open-label, randomised, phase 3 trial // Lancet Oncol. 2018;19(12):1630–1640. doi:10.1016/S1470-2045(18)30570-9
Santonja A, Sánchez-Muñoz A, Lluch A et al. Triple negative breast cancer subtypes and pathologic complete response rate to neoadjuvant chemotherapy // Oncotarget. 2018;9(41):26406–26416. doi:10.18632/oncotarget.25413
Samiei S, van Nijnatten TJA, de Munck L et al. Correlation Between Pathologic Complete Response in the Breast and Absence of Axillary Lymph Node Metastases After Neoadjuvant Systemic Therapy // Ann Surg. 2020;271(3):574–580. doi:10.1097/SLA.0000000000003126
Barron AU, Hoskin TL, Day CN et al. Association of Low Nodal Positivity Rate Among Patients With ERBB2-Positive or Triple-Negative Breast Cancer and Breast Pathologic Complete Response to Neoadjuvant Chemotherapy // JAMA Surg. 2018;153(12):1120–1126. doi:10.1001/jamasurg.2018.2696
Tadros AB, Yang WT, Krishnamurthy S et al. Identification of Patients With Documented Pathologic Complete Response in the Breast After Neoadjuvant Chemotherapy for Omission of Axillary Surgery // JAMA Surg. 2017;152(7):665–670. doi:10.1001/jamasurg.2017.0562
Morrow M, Khan AJ. Locoregional Management After Neoadjuvant Chemotherapy // J Clin Oncol. 2020;38(20):2281–2289. doi:10.1200/JCO.19.02576
Patey DH, Dyson WH. The prognosis of carcinoma of the breast in relation to the type of operation performed // Br J Cancer. 1948;2(1):7–13. doi:10.1038/bjc.1948.2
Madden JL. Modified radical mastectomy // Surg Gynecol Obstet. 1965;121(6):1221–1230
Sakorafas GH, Safioleas M. Breast cancer surgery: an historical narrative. Part III. From the sunset of the 19th to the dawn of the 21st century // Eur J Cancer Care (Engl). 2010;19(2):145–166. doi:10.1111/j.1365-2354.2008.01061.x
Blichert-Toft M, Rose C, Andersen JA et al. Danish randomized trial comparing breast conservation therapy with mastectomy: six years of life-table analysis. Danish Breast Cancer Cooperative Group // J Natl Cancer Inst Monogr. 1992;(11):19–25.
Semiglazov VF et al. Breast-conserving surgery after neoadjuvant therapy for breast cancer // Voprosy onkologii. 2015;61(3):381–386.
Fisher B, Redmond C, Poisson R et al. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer // N Engl J Med. 1989;320(13):822–828. doi:10.1056/NEJM198903303201302
Veronesi U, Salvadori B, Luini A et al. Conservative treatment of early breast cancer. Long-term results of 1232 cases treated with quadrantectomy, axillary dissection, and radiotherapy // Ann Surg. 1990;211(3):250–259.
Lichter AS, Lippman ME, Danforth DNJr et al. Mastectomy versus breast-conserving therapy in the treatment of stage I and II carcinoma of the breast: a randomized trial at the National Cancer Institute // J Clin Oncol. 1992;10(6):976–983. doi:10.1200/JCO.1992.10.6.976
van Dongen JA, Bartelink H, Fentiman IS et al. Randomized clinical trial to assess the value of breast-conserving therapy in stage I and II breast cancer, EORTC 10801 trial // J Natl Cancer Inst Monogr. 1992;(11):15–18.
Sarrazin D, Lê MG, Arriagada R et al. Ten-year results of a randomized trial comparing a conservative treatment to mastectomy in early breast cancer // Radiother Oncol. 1989;14(3):177–184. doi:10.1016/0167-8140(89)90165-5
Fisher B, Anderson S, Bryant J et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer // N Engl J Med. 2002;347(16):1233–1241. doi:10.1056/NEJMoa022152
van Dongen JA, Voogd AC, Fentiman IS et al. Long-term results of a randomized trial comparing breast-conserving therapy with mastectomy: European Organization for Research and Treatment of Cancer 10801 trial // J Natl Cancer Inst. 2000;92(14):1143–1150. doi:10.1093/jnci/92.14.1143
Veronesi U, Cascinelli N, Mariani L et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer // N Engl J Med. 2002;347(16):1227–1232. doi:10.1056/NEJMoa020989
Poggi MM, Danforth DN, Sciuto LC et al. Eighteen-year results in the treatment of early breast carcinoma with mastectomy versus breast conservation therapy: the National Cancer Institute Randomized Trial // Cancer. 2003;98(4):697–702. doi:10.1002/cncr.11580
Arriagada R, Lê MG, Rochard F, Contesso G. Conservative treatment versus mastectomy in early breast cancer: patterns of failure with 15 years of follow-up data. Institut Gustave-Roussy Breast Cancer Group // J Clin Oncol. 1996;14(5):1558–1564. doi:10.1200/JCO.1996.14.5.1558
Jatoi I, Proschan MA. Randomized trials of breast-conserving therapy versus mastectomy for primary breast cancer: a pooled analysis of updated results // Am J Clin Oncol. 2005;28(3):289–294. doi:10.1097/01.coc.0000156922.58631.d7
Международные реокщмендации по лечению раннего рака молочной железы: рук. для врачей / Под ред. В.Ф. Семиглазова. М.: МК, 2020.
Burstein HJ, Curigliano G, Loibl S et al. Estimating the benefits of therapy for early-stage breast cancer: the St. Gallen International Consensus Guidelines for the primary therapy of early breast cancer 2019 // Ann Oncol. 2019;30(10):1541–1557. doi:10.1093/annonc/mdz235
Rubens RD, Sexton S, Tong D et al. Combined chemotherapy and radiotherapy for locally advanced breast cancer // Eur J Cancer. 1980;16(3):351–356. doi:10.1016/0014-2964(80)90352-7
Rastogi P, Anderson SJ, Bear HD et al. Preoperative chemotherapy: updates of National Surgical Adjuvant Breast and Bowel Project Protocols B-18 and B-27 // J Clin Oncol. 2008;26(5):778–785. doi:10.1200/JCO.2007.15.0235
Bonadonna G, Veronesi U, Brambilla C et al. Primary chemotherapy to avoid mastectomy in tumors with diameters of three centimeters or more // J Natl Cancer Inst. 1990;82(19):1539–1545. doi:10.1093/jnci/82.19.1539
Fisher B, Brown A, Mamounas E et al. Effect of preoperative chemotherapy on local-regional disease in women with operable breast cancer: findings from National Surgical Adjuvant Breast and Bowel Project B-18 // J Clin Oncol. 1997;15(7):2483–2493. doi:10.1200/JCO.1997.15.7.2483
van der Hage JA, van de Velde CJ, Julien JP et al. Preoperative chemotherapy in primary operable breast cancer: results from the European Organization for Research and Treatment of Cancer trial 10902 // J Clin Oncol. 2001;19(22):4224–4237. doi:10.1200/JCO.2001.19.22.4224
Golshan M, Cirrincione CT, Sikov WM et al. Impact of neoadjuvant therapy on eligibility for and frequency of breast conservation in stage II–III HER2-positive breast cancer: surgical results of CALGB 40601 (Alliance) // Breast Cancer Res Treat. 2016;160(2):297–304. doi:10.1007/s10549-016-4006-6
Golshan M, Cirrincione CT, Sikov WM et al. Impact of neoadjuvant chemotherapy in stage II–III triple negative breast cancer on eligibility for breast-conserving surgery and breast conservation rates: surgical results from CALGB 40603 (Alliance) // Ann Surg. 2015;262(3):434–439. doi:10.1097/SLA.0000000000001417
Semiglazov VF, Semiglazov V, Ivanov V et al. The relative efficacy of neoadjuvant endocrine therapy vs chemotherapy in postmenopausal women with ER- positive breast cancer // Journal of Clinical Oncology. 2004 22:14(suppl):519–519.
Bear HD, Anderson S, Brown A et al. The effect on tumor response of adding sequential preoperative docetaxel to preoperative doxorubicin and cyclophosphamide: preliminary results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27 // J Clin Oncol. 2003;21(22):4165–4174. doi:10.1200/JCO.2003.12.005
Criscitiello C, Golshan M, Barry WT et al. Impact of neoadjuvant chemotherapy and pathological complete response on eligibility for breast-conserving surgery in patients with early breast cancer: A meta-analysis // Eur J Cancer. 2018;97:1–6. doi:10.1016/j.ejca.2018.03.023
Early Breast Cancer Trialists' Collaborative Group (EBCTCG). Long-term outcomes for neoadjuvant versus adjuvant chemotherapy in early breast cancer: meta-analysis of individual patient data from ten randomised trials // Lancet Oncol. 2018;19(1):27–39. doi:10.1016/S1470-2045(17)30777-5
Swisher SK, Vila J, Tucker SL et al. Locoregional Control According to Breast Cancer Subtype and Response to Neoadjuvant Chemotherapy in Breast Cancer Patients Undergoing Breast-conserving Therapy // Ann Surg Oncol. 2016;23(3):749–756. doi:10.1245/s10434-015-4921-5
Cortazar P, Zhang L, Untch M et al. Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis // Lancet. 2014;384(9938):164–172. doi:10.1016/S0140-6736(13)62422-8
Valachis A, Mamounas EP, Mittendorf EA et al. Risk factors for locoregional disease recurrence after breast-conserving therapy in patients with breast cancer treated with neoadjuvant chemotherapy: An international collaboration and individual patient meta-analysis // Cancer. 2018;124(14):2923–2930. doi:10.1002/cncr.31518
von Minckwitz G, Untch M, Blohmer JU et al. Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes // J Clin Oncol. 2012;30(15):1796–1804. doi:10.1200/JCO.2011.38.8595
Schaefgen B, Mati M, Sinn HP et al. Can Routine Imaging After Neoadjuvant Chemotherapy in Breast Cancer Predict Pathologic Complete Response? // Ann Surg Oncol. 2016;23(3):789–795. doi:10.1245/s10434-015-4918-0
Heil J, Kuerer HM, Pfob A et al. Eliminating the breast cancer surgery paradigm after neoadjuvant systemic therapy: current evidence and future challenges // Ann Oncol. 2020;31(1):61–71. doi:10.1016/j.annonc.2019.10.012
Криворотько П.В. и др. К вопросу об интерпретации результатов сцинтиграфии с 99m Tc-Технетрилом у больных РМЖ // Эффективная фармакотерапия. 2013(6.):24–31.
National Collaborating Centre for Cancer (UK). Early and Locally Advanced Breast Cancer: Diagnosis and Treatment. Cardiff (UK): National Collaborating Centre for Cancer (UK); February 2009
Semiglazov V. How to handle breast cancer patient with complete response following neoadjuvant chemotherapy? // EJSO. 2008;1025.
Kuerer HM, Vrancken Peeters MTFD, Rea DW et al. Nonoperative Management for Invasive Breast Cancer After Neoadjuvant Systemic Therapy: Conceptual Basis and Fundamental International Feasibility Clinical Trials // Ann Surg Oncol. 2017;24(10):2855–2862. doi:10.1245/s10434-017-5926-z
Krag DN, Anderson SJ, Julian TB et al. Sentinel-lymph-node resection compared with conventional axillary-lymph-node dissection in clinically node-negative patients with breast cancer: overall survival findings from the NSABP B-32 randomised phase 3 trial // Lancet Oncol. 2010;11(10):927–933. doi:10.1016/S1470-2045(10)70207-2
Fowler AM, Mankoff DA, Joe BN. Imaging Neoadjuvant Therapy Response in Breast Cancer // Radiology. 2017;285(2):358–375. doi:10.1148/radiol.2017170180
Li H, Yao L, Jin P et al. MRI and PET/CT for evaluation of the pathological response to neoadjuvant chemotherapy in breast cancer: A systematic review and meta-analysis // Breast. 2018;40:106–115. doi:10.1016/j.breast.2018.04.018
Rauch GM, Adrada BE, Kuerer HM et al. Multimodality Imaging for Evaluating Response to Neoadjuvant Chemotherapy in Breast Cancer // AJR Am J Roentgenol. 2017;208(2):290–299. doi:10.2214/AJR.16.17223
Schaefgen B, Mati M, Sinn HP et al. Can Routine Imaging After Neoadjuvant Chemotherapy in Breast Cancer Predict Pathologic Complete Response? // Ann Surg Oncol. 2016;23(3):789–795. doi:10.1245/s10434-015-4918-0
von Minckwitz G, Huang CS, Mano MS et al. Trastuzumab Emtansine for Residual Invasive HER2-Positive Breast Cancer // N Engl J Med. 2019;380(7):617–628. doi:10.1056/NEJMoa1814017
Heil J, Kümmel S, Schaefgen B et al. Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques // Br J Cancer. 2015;113:1565–1570. doi:10.1038/bjc.2015.381
Kuerer HM, Rauch GM, Krishnamurthy S et al. A Clinical Feasibility Trial for Identification of Exceptional Responders in Whom Breast Cancer Surgery Can Be Eliminated Following Neoadjuvant Systemic Therapy // Ann Surg. 2018;267(5):946–951. doi:10.1097/SLA.0000000000002313
Heil J, Richter H, Golatta M, Sinn HP. Vacuum-Assisted Biopsy to Diagnose a Pathological Complete Response in Breast Cancer Patients After Neoadjuvant Systemic Therapy // Ann Surg. 2018;268(6):e60–e61. doi:10.1097/SLA.0000000000002572
Abstract GS5-05: Primary analysis of NRG-BR005, a phase II trial assessing accuracy of tumor bed biopsies in predicting pathologic complete response (pCR) in patients with clinical/radiological complete response after neoadjuvant chemotherapy (NCT) to explore the feasibility of breast-conserving treatment without surgery. Mark Basik, Reena S Cecchini, Jennifer F De Los Santos, Heidi R Umphrey, Thomas B Julian, Eleftherios P Mamounas, Julia White, Peter C Lucas, Christa Balanoff, Antoinette R Tan, Joseph J. Weber, David A Edmonson, Ursa A. Brown-Glaberman, Emilia J. Diego, Mediget Teshome, Cindy B Matsen, Samantha A Seaward, Irene L. Wapnir, Jamie L Wagner, Judy A Tjoe, Alastair M Thompson and Norman Wolmark // Cancer Res. 2020;80(Suppl. 4):GS5–05. doi:10.1158/1538-7445.SABCS19-GS5-05
van Loevezijn AA, van der Noordaa MEM, van Werkhoven ED et al. Minimally Invasive Complete Response Assessment of the Breast After Neoadjuvant Systemic Therapy for Early Breast Cancer (MICRA trial): Interim Analysis of a Multicenter Observational Cohort Study // Ann Surg Oncol. 2021;28(6):3243–3253. doi:10.1245/s10434-020-09273-0
Tasoulis MK, Lee HB, Yang W et al. Accuracy of Post-Neoadjuvant Chemotherapy Image-Guided Breast Biopsy to Predict Residual Cancer // JAMA Surg. 2020;155(12):e204103. doi:10.1001/jamasurg.2020.4103
Gärtner R, Jensen MB, Nielsen J et al. Prevalence of and factors associated with persistent pain following breast cancer // JAMA. 2009;302(18):1985-1992. doi:10.1001/jama.2009.1568
Flanagan MR, Zabor EC, Romanoff A et al. A Comparison of Patient-Reported Outcomes After Breast-Conserving Surgery and Mastectomy with Implant Breast Reconstruction // Ann Surg Oncol. 2019;26(10):3133–3140. doi:10.1245/s10434-019-07548-9
Gent HJ, Sprenger E, Dowlatshahi K. Stereotaxic needle localization and cytological diagnosis of occult breast lesions // Ann Surg. 1986;204(5):580–584. doi:10.1097/00000658-198611000-00012
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