Advances in the diagnosis of pathological response by a second biopsy in breast cancer neoadjuvant therapy and their clinical significance

Bingqi XU; Guoqiang ZHANG

doi:10.19401/j.cnki.1007-3639.2022.04.006

您当前的位置：

首页 >

文章列表页 >

Advances in the diagnosis of pathological response by a second biopsy in breast cancer neoadjuvant therapy and their clinical significance

Review | 更新时间：2025-12-31

- Advances in the diagnosis of pathological response by a second biopsy in breast cancer neoadjuvant therapy and their clinical significance
- China Oncology Vol. 32, Issue 4, Pages: 335-342(2022)
- 作者机构：
  
  哈尔滨医科大学附属肿瘤医院乳腺整形病房,黑龙江哈尔滨 150086
- 作者简介：
- 基金信息：
- DOI：10.19401/j.cnki.1007-3639.2022.04.006
  CLC： R737.9
- Received：25 February 2021，
  
  Revised：2021-07-25，
  
  Published：30 April 2022
- 稿件说明：
移动端阅览
Bingqi XU, Guoqiang ZHANG. Advances in the diagnosis of pathological response by a second biopsy in breast cancer neoadjuvant therapy and their clinical significance[J]. China Oncology, 2022, 32(4): 335-342.
DOI：

Bingqi XU, Guoqiang ZHANG. Advances in the diagnosis of pathological response by a second biopsy in breast cancer neoadjuvant therapy and their clinical significance[J]. China Oncology, 2022, 32(4): 335-342. DOI： 10.19401/j.cnki.1007-3639.2022.04.006.

摘要

随着乳腺癌新辅助治疗的发展

病理学完全缓解率明显提高。对于已经达到病理学完全缓解的患者

使用局域放疗替代手术治疗在理论上可行

因此术前准确判断病理学完全缓解至关重要。新辅助化疗后二次活检因其对病理学完全缓解预测准确率较高而被认为是有希望替代手术诊断病理学完全缓解的方法。最近发表的几项国外的前瞻性临床试验结果表明

新辅助化疗后二次活检具有相对较高的假阴性率

对新辅助化疗反应极好的患者豁免手术仍需要进一步研究。本文首先阐述二次活检的临床应用及其意义

并将国外已发表的临床研究分为小型可行性研究和大型前瞻性研究

对其主要结果及特点进行分析。

Abstract

With the development of neoadjuvant therapy

the pathological complete response rate has significantly increased for breast cancer patients.Theoretically

the use of locoregional radiotherapy instead of surgery is available for patients with pathological complete response

thus it is essential to predict pathological complete response precisely before surgery. Due to its higher accuracy for assessing the pathological complete response

the second biopsy after neoadjuvant chemotherapy is believed to have potential for diagnosing pathological complete response instead of surgery. Recently several published prospective trials showed the relatively high false negative rates of the second biopsy and omitting surgery for the exceptional responders to neoadjuvant chemotherapy required further investigation. This review elaborated on the clinical utility and significance of the second biopsy firstly and divided these studies into small feasible research and large prospective research in which the results and features were discussed.

关键词

Keywords

references

CASTRELLON A B , PIDHORECKY I , VALERO V , et al . The role of carboplatin in the neoadjuvant chemotherapy treatment of triple negative breast cancer [J ] . Oncol Rev , 2017 , 11 ( 1 ): 324 .

GIANNI L , PIENKOWSKI T , IM Y H , et al . Efficacy and safety of neoadjuvant pertuzumab and trastuzumab in women with locally advanced, inflammatory, or early HER2-positive breast cancer (NeoSphere): a randomised multicentre, open-label, phase 2 trial [J ] . Lancet Oncol , 2012 , 13 ( 1 ): 25 - 32 . DOI: 10.1016/S1470-2045(11)70336-9 http://doi.org/10.1016/S1470-2045(11)70336-9 https://linkinghub.elsevier.com/retrieve/pii/S1470204511703369 https://linkinghub.elsevier.com/retrieve/pii/S1470204511703369

GOLSHAN M , CIRRINCIONE C T , SIKOV W M , 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) [J ] . Breast Cancer Res Treat , 2016 , 160 ( 2 ): 297 - 304 . DOI: 10.1007/s10549-016-4006-6 http://doi.org/10.1007/s10549-016-4006-6 https://doi.org/10.1007/s10549-016-4006-6 https://doi.org/10.1007/s10549-016-4006-6

GOLSHAN M , CIRRINCIONE C T , SIKOV W M , 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) [J ] . Ann Surg , 2015 , 262 ( 3 ): 434-439; discussion 438-439.

RING A , WEBB A , ASHLEY S , et al . Is surgery necessary after complete clinical remission following neoadjuvant chemotherapy for early breast cancer? [J ] . J Clin Oncol , 2003 , 21 ( 24 ): 4540 - 4545 . DOI: 10.1200/JCO.2003.05.208 http://doi.org/10.1200/JCO.2003.05.208 http://ascopubs.org/doi/10.1200/JCO.2003.05.208 http://ascopubs.org/doi/10.1200/JCO.2003.05.208

VAN LA PARRA R F D , KUERER H M . Selective elimination of breast cancer surgery in exceptional responders: historical perspective and current trials [J ] . Breast Cancer Res , 2016 , 18 ( 1 ): 28 . DOI: 10.1186/s13058-016-0684-6 http://doi.org/10.1186/s13058-016-0684-6 http://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-016-0684-6 http://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-016-0684-6

PEINTINGER F , KUERER H M , ANDERSON K , et al . Accuracy of the combination of mammography and sonography in predicting tumor response in breast cancer patients after neoadjuvant chemotherapy [J ] . Ann Surg Oncol , 2006 , 13 ( 11 ): 1443 - 1449 . DOI: 10.1245/s10434-006-9086-9 http://doi.org/10.1245/s10434-006-9086-9 http://link.springer.com/10.1245/s10434-006-9086-9 http://link.springer.com/10.1245/s10434-006-9086-9

KEUNE J D , JEFFE D B , SCHOOTMAN M , et al . Accuracy of ultrasonography and mammography in predicting pathologic response after neoadjuvant chemotherapy for breast cancer [J ] . Am J Surg , 2010 , 199 ( 4 ): 477 - 484 . DOI: 10.1016/j.amjsurg.2009.03.012 http://doi.org/10.1016/j.amjsurg.2009.03.012 https://linkinghub.elsevier.com/retrieve/pii/S000296100900258X https://linkinghub.elsevier.com/retrieve/pii/S000296100900258X

SHAH S K , SHAH S K , GREATREX K V . Current role of magnetic resonance imaging in breast imaging: a primer for the primary care physician [J ] . J Am Board Fam Pract , 2005 , 18 ( 6 ): 478 - 490 . DOI: 10.3122/jabfm.18.6.478 http://doi.org/10.3122/jabfm.18.6.478 http://www.jabfm.org/cgi/doi/10.3122/jabfm.18.6.478 http://www.jabfm.org/cgi/doi/10.3122/jabfm.18.6.478

CROSHAW R , SHAPIRO-WRIGHT H , SVENSSON E , et al. Accuracy of clinical examination, digital mammogram, ultrasound, and MRI in determining post neoadjuvant pathologic tumor response in operable breast cancer patients [J ] . Ann Surg Oncol , 2011 , 18 ( 11 ): 3160 - 3163 . DOI: 10.1245/s10434-011-1919-5 http://doi.org/10.1245/s10434-011-1919-5 http://link.springer.com/10.1245/s10434-011-1919-5 http://link.springer.com/10.1245/s10434-011-1919-5

KUERER H M , VRANCKEN PEETERS M T F D , REA D W , et al . Nonoperative management for invasive breast cancer after neoadjuvant systemic therapy: conceptual basis and fundamental international feasibility clinical trials [J ] . Ann Surg Oncol , 2017 , 24 ( 10 ): 2855 - 2862 . DOI: 10.1245/s10434-017-5926-z http://doi.org/10.1245/s10434-017-5926-z http://link.springer.com/10.1245/s10434-017-5926-z http://link.springer.com/10.1245/s10434-017-5926-z

HEIL J , KÜMMEL S , SCHAEFGEN B , et al . Diagnosis of pathological complete response to neoadjuvant chemotherapy in breast cancer by minimal invasive biopsy techniques [J ] . Br J Cancer , 2015 , 113 ( 11 ): 1565 - 1570 . DOI: 10.1038/bjc.2015.381 http://doi.org/10.1038/bjc.2015.381 https://doi.org/10.1038/bjc.2015.381 https://doi.org/10.1038/bjc.2015.381

MAURI D , PAVLIDIS N , IOANNIDIS J P A . Neoadjuvant versus adjuvant systemic treatment in breast cancer: a meta-analysis [J ] . J Natl Cancer Inst , 2005 , 97 ( 3 ): 188 - 194 . DOI: 10.1093/jnci/dji021 http://doi.org/10.1093/jnci/dji021 https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/dji021 https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/dji021

RASTOGI P , ANDERSON S J , BEAR H D , et al . Preoperative chemotherapy: updates of national surgical adjuvant breast and bowel project protocols B-18 and B-27 [J ] . J Clin Oncol , 2008 , 26 ( 5 ): 778 - 785 . DOI: 10.1200/JCO.2007.15.0235 http://doi.org/10.1200/JCO.2007.15.0235 http://ascopubs.org/doi/10.1200/JCO.2007.15.0235 http://ascopubs.org/doi/10.1200/JCO.2007.15.0235

CORTAZAR P , ZHANG L J , UNTCH M , et al . Pathological complete response and long-term clinical benefit in breast cancer: the CTNeoBC pooled analysis [J ] . Lancet , 2014 , 384 ( 9938 ): 164 - 172 . DOI: 10.1016/S0140-6736(13)62422-8 http://doi.org/10.1016/S0140-6736(13)62422-8 https://linkinghub.elsevier.com/retrieve/pii/S0140673613624228 https://linkinghub.elsevier.com/retrieve/pii/S0140673613624228

ZHANG Y , SHEN J P , WU S Y , et al . The use of a second core needle biopsy to predict response to neoadjuvant chemotherapy in breast cancer patients, especially in the HER2-positive population [J ] . Surgery , 2020 , 168 ( 6 ): 1115 - 1121 . DOI: 10.1016/j.surg.2020.06.045 http://doi.org/10.1016/j.surg.2020.06.045 https://linkinghub.elsevier.com/retrieve/pii/S003960602030444X https://linkinghub.elsevier.com/retrieve/pii/S003960602030444X

MASUDA N , LEE S J , OHTANI S , et al . Adjuvant capecitabine for breast cancer after preoperative chemotherapy [J ] . N Engl J Med , 2017 , 376 ( 22 ): 2147 - 2159 . DOI: 10.1056/NEJMoa1612645 http://doi.org/10.1056/NEJMoa1612645 http://www.nejm.org/doi/10.1056/NEJMoa1612645 http://www.nejm.org/doi/10.1056/NEJMoa1612645

VON MINCKWITZ G , HUANG C S , MANO M S , et al . Trastuzumab emtansine for residual invasive HER2-positive breast cancer [J ] . N Engl J Med , 2019 , 380 ( 7 ): 617 - 628 . DOI: 10.1056/NEJMoa1814017 http://doi.org/10.1056/NEJMoa1814017 http://www.nejm.org/doi/10.1056/NEJMoa1814017 http://www.nejm.org/doi/10.1056/NEJMoa1814017

VON MINCKWITZ G , KÜMMEL S , VOGEL P , et al . Neoadjuvant vinorelbine-capecitabine versus docetaxel-doxorubicin-cyclophosphamide in early nonresponsive breast cancer: phase Ⅲ randomized GeparTrio trial [J ] . J Natl Cancer Inst , 2008 , 100 ( 8 ): 542 - 551 . DOI: 10.1093/jnci/djn085 http://doi.org/10.1093/jnci/djn085 https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djn085 https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djn085

邵志敏 , 江泽飞 , 李俊杰 , 等 . 中国乳腺癌新辅助治疗专家共识(2019年版) [J ] . 中国癌症杂志 , 2019 , 29 ( 5 ): 390 - 400 .

SHAO Z M , JIANG Z F , LI J J , et al . Expert consensus on neoadjuvant therapy for breast cancer in China (2019 edition) [J ] . China Oncol , 2019 , 29 ( 5 ): 390 - 400 .

中国抗癌协会乳腺癌专业委员会 . 中国抗癌协会乳腺癌诊治指南与规范(2021年版) [J ] . 中国癌症杂志 , 2021 , 31 ( 10 ): 954 - 1040 .

The Society of Breast Cancer China Anti-Cancer Association . Guidelines for breast cancer diagnosis and treatment by China Anti-Cancer Association (2021 edition) [J ] . China Oncol , 2021 , 31 ( 10 ): 954 - 1040 .

中国临床肿瘤学会指南工作委员会组织 . 中国临床肿瘤学会(CSCO)乳腺癌诊疗指南-2021 [M ] . 北京 : 人民卫生出版社 , 2021 .

SPRING L M , FELL G , ARFE A , et al . Pathologic complete response after neoadjuvant chemotherapy and impact on breast cancer recurrence and survival: a comprehensive meta-analysis [J ] . Clin Cancer Res , 2020 , 26 ( 12 ): 2838 - 2848 . DOI: 10.1158/1078-0432.CCR-19-3492 http://doi.org/10.1158/1078-0432.CCR-19-3492 http://clincancerres.aacrjournals.org/lookup/doi/10.1158/1078-0432.CCR-19-3492 http://clincancerres.aacrjournals.org/lookup/doi/10.1158/1078-0432.CCR-19-3492

XIE Y F , WU S Y , ZHANG Y , et al . Optimal duration of neoadjuvant taxane and carboplatin combined with anti-HER2 targeted therapy for HER2-positive breast cancer [J ] . Front Oncol , 2021 , 11 : 686591 . DOI: 10.3389/fonc.2021.686591 http://doi.org/10.3389/fonc.2021.686591 https://www.frontiersin.org/articles/10.3389/fonc.2021.686591/full https://www.frontiersin.org/articles/10.3389/fonc.2021.686591/full

HEIL J , SCHAEFGEN B , SINN P , et al . Can a pathological complete response of breast cancer after neoadjuvant chemotherapy be diagnosed by minimal invasive biopsy? [J ] . Eur J Cancer , 2016 , 69 : 142 - 150 . DOI: 10.1016/j.ejca.2016.09.034 http://doi.org/10.1016/j.ejca.2016.09.034 https://linkinghub.elsevier.com/retrieve/pii/S0959804916324807 https://linkinghub.elsevier.com/retrieve/pii/S0959804916324807

KUERER H M , RAUCH G M , 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 [J ] . Ann Surg , 2018 , 267 ( 5 ): 946 - 951 . DOI: 10.1097/SLA.0000000000002313 http://doi.org/10.1097/SLA.0000000000002313 https://journals.lww.com/00000658-201805000-00027 https://journals.lww.com/00000658-201805000-00027

FRANCIS A , HERRING K , MOLYNEUX R , et al. Abstract P5-16-14: NOSTRA PRELIM: a non randomised pilot study designed to assess the ability of image guided core biopsies to detect residual disease in patients with early breast cancer who have received neoadjuvant chemotherapy to inform the design of a planned trial [C ] //. Poster Session Abstracts. American Association for Cancer Research , 2017 .

LEE H B , HAN W , KIM S Y , et al . Prediction of pathologic complete response using image-guided biopsy after neoadjuvant chemotherapy in breast cancer patients selected based on MRI findings: a prospective feasibility trial [J ] . Breast Cancer Res Treat , 2020 , 182 ( 1 ): 97 - 105 . DOI: 10.1007/s10549-020-05678-3 http://doi.org/10.1007/s10549-020-05678-3 https://doi.org/10.1007/s10549-020-05678-3 https://doi.org/10.1007/s10549-020-05678-3

LOEVEZIJN A V , VAN DER NOORDAA M E M , VAN WERKHOVEN E , et al . Minimally invasive complete response assessment of the breast after neoadjuvant systemic therapy (MICRA trial): interim analysis of a multicenter observational cohort study [J ] . Eur J Cancer , 2020 , 138 : S9-S10 .

HEIL J , PFOB A , SINN H P P , et al. Abstract GS5-03: Diagnosing residual disease and pathologic complete response after neoadjuvant chemotherapy in breast cancer patients by image-guided vacuum-assisted breast biopsy: results of a prospective multicenter trial [C ] // . General session abstracts. American Association for Cancer Research , 2020 .

MARK BASIK R S C , JENNIFER F DE LOS SANTOS H R U , THOMAS B JULIAN E P M , et al. 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 [C ] . 2020 , 80 ( Suppl 4 ): 5.

TASOULIS M K , LEE H B , YANG W , et al . Accuracy of post-neoadjuvant chemotherapy image-guided breast biopsy to predict residual cancer [J ] . JAMA Surg , 2020 , 155 ( 12 ): e204103 . DOI: 10.1001/jamasurg.2020.4103 http://doi.org/10.1001/jamasurg.2020.4103 https://jamanetwork.com/journals/jamasurgery/fullarticle/2771053 https://jamanetwork.com/journals/jamasurgery/fullarticle/2771053

VAN DER NOORDAA M E M , VAN DUIJNHOVEN F H , LOO C E , et al . Identifying pathologic complete response of the breast after neoadjuvant systemic therapy with ultrasound guided biopsy to eventually omit surgery: study design and feasibility of the MICRA trial (minimally invasive complete response assessment) [J ] . Breast , 2018 , 40 : 76 - 81 . DOI: 10.1016/j.breast.2018.04.015 http://doi.org/10.1016/j.breast.2018.04.015 https://linkinghub.elsevier.com/retrieve/pii/S096097761830078X https://linkinghub.elsevier.com/retrieve/pii/S096097761830078X

HEIL J , SINN P , RICHTER H , et al . RESPONDER-diagnosis of pathological complete response by vacuum-assisted biopsy after neoadjuvant chemotherapy in breast cancer-a multicenter, confirmative, one-armed, intra-individually-controlled, open, diagnostic trial [J ] . BMC Cancer , 2018 , 18 ( 1 ): 851 . DOI: 10.1186/s12885-018-4760-4 http://doi.org/10.1186/s12885-018-4760-4 https://doi.org/10.1186/s12885-018-4760-4 https://doi.org/10.1186/s12885-018-4760-4

LI Y , ZHOU Y D , MAO F , et al . The diagnostic performance of minimally invasive biopsy in predicting breast pathological complete response after neoadjuvant systemic therapy in breast cancer: a meta-analysis [J ] . Front Oncol , 2020 , 10 : 933 . DOI: 10.3389/fonc.2020.00933 http://doi.org/10.3389/fonc.2020.00933 https://www.frontiersin.org/article/10.3389/fonc.2020.00933/full https://www.frontiersin.org/article/10.3389/fonc.2020.00933/full

PFOB A , SIDEY-GIBBONS C , LEE H B , et al . Identification of breast cancer patients with pathologic complete response in the breast after neoadjuvant systemic treatment by an intelligent vacuum-assisted biopsy [J ] . Eur J Cancer , 2021 , 143 : 134 - 146 . DOI: 10.1016/j.ejca.2020.11.006 http://doi.org/10.1016/j.ejca.2020.11.006 https://linkinghub.elsevier.com/retrieve/pii/S0959804920313253 https://linkinghub.elsevier.com/retrieve/pii/S0959804920313253

Views

2589

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Predictive value of plasma long non-coding RNA H19 in neoadjuvant therapy for breast cancer

A study of neutrophil to lymphocyte ratio for the prediction of axillary pathological complete response after neoadjuvant therapy in breast cancer

Axillary management after neoadjuvant therapy for breast cancer and optimization of sentinel lymph node diagnosis and treatment

Research progress and prospects of MRI in predicting lymph node status in breast cancer

Progress and future prospects in local and systemic treatment of early breast cancer

Related Author

Anli CHEN

Haoyuan SHEN

Shixiong YANG

Chunyan DENG

Chaohua HU

Hanzhong LIU

Shu WANG

Fang QIAN

Related Institution

Postgraduate Training Base of Xiaogan Central Hospital of Jinzhou Medical University

Department of Thyroid and Breast Surgery, Affiliated Hospital of Wuhan University of Science and Technology (Xiaogan Central Hospital)

Department of Central Laboratory, Affiliated Hospital of Wuhan University of Science and Technology (Xiaogan Central Hospital)

Department of Pediatrics, Affiliated Hospital of Wuhan University of Science and Technology (Xiaogan Central Hospital)

Department of Pathology, Affiliated Hospital of Wuhan University of Science and Technology (Xiaogan Central Hospital)

AI问答

⁰