Neoadjuvant chemotherapy (NAT) plays a crucial role in breast cancer (BC) treatment, both in advanced BC and in early-stage BC, with different rates of pathological complete response (pCR) among the different BC molecular subtypes. Imaging monitoring is mandatory to evaluate the NAT efficacy. This study evaluates the diagnostic performance of Contrast-Enhanced Mammography (CEM) in BC patients undergoing NAT. This retrospective two-center study included 174 patients. The breast lesions were classified based on the molecular subtypes in hormone receptor (HR+)/HER2−, HER2+, and triple-negative breast cancer (TNBC). The histopathological analysis performed following surgery was used as a reference standard for the pCR. Sensitivity, specificity, PPV, and NPV were measured overall and for the different subtypes. We enrolled 174 patients, 79/174 (46%) HR+/HER2−, 59/174 (33.9%) HER2+, and 35/174 (20.1%) TNBC; the pCR was found in 64/174 (36.8%), of which 57.1% were TNBCs. In the total population, the CEM sensitivity and specificity were 66.2% and 75.2%, with a PPV of 61.4% and an NPV of 78.8%. The highest specificity (80.9%) and NPV (91.7%) were found in HR+/HER2−, while the highest sensitivity (70%) and PPV appeared (73.7%) in TNBC. The results indicate that CEM is a valid tool to assess the pCR, with different performances among the subtypes of BC.
新辅助化疗（NAT）在乳腺癌（BC）治疗中发挥着关键作用，无论是对于晚期还是早期乳腺癌，不同分子亚型的病理完全缓解（pCR）率存在差异。影像学监测对于评估NAT疗效至关重要。本研究评估了对比增强乳腺X线摄影（CEM）在接受NAT的BC患者中的诊断性能。这项回顾性双中心研究纳入了174名患者。根据分子亚型将乳腺病灶分为激素受体阳性/HER2阴性（HR+/HER2−）、HER2阳性（HER2+）和三阴性乳腺癌（TNBC）。术后进行的组织病理学分析被用作pCR的参考标准。我们计算了总体及各亚型的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。研究共纳入174名患者，其中HR+/HER2− 79例（46%），HER2+ 59例（33.9%），TNBC 35例（20.1%）；pCR率为64/174（36.8%），其中TNBC的pCR率为57.1%。在总体人群中，CEM的敏感性和特异性分别为66.2%和75.2%，PPV为61.4%，NPV为78.8%。HR+/HER2−亚型显示出最高的特异性（80.9%）和NPV（91.7%），而TNBC亚型则表现出最高的敏感性（70%）和PPV（73.7%）。结果表明，CEM是评估pCR的有效工具，但其性能在BC不同亚型间存在差异。
肿瘤(癌症)患者之家