engleski

Role of imaging in neoadjuvant therapy for breast cancer

Breast cancer is the most commonly diagnosed cancer among the female population worldwide. Breast cancer mortality has declined over the last few decades primarily due to a combination of early detection by screening mammography and the development of more effective therapeutic options. Breast cancer is a highly heterogeneous disease that comes in several histological subtypes which exhibit different clinical presentations and differ in therapy response. There are several treatment options available for the treatment of breast cancer depending on the tumor subtype and the stage of the disease including local treatment (surgery or radiation therapy) and systemic treatment (chemotherapy, targeted therapy or endocrine therapy). Neoadjuvant therapy refers to the use of systemic therapy before surgery, and if efficient, it may cause downstaging of the tumor and the axilla, and consequently reduce the extent of the surgical procedure. In terms of breast cancer, imaging is crucial for detection, staging, and monitoring treatment success. Magnetic resonance imaging of the breast is important in evaluating response to neoadjuvant therapy. Dramatic response to neoadjuvant therapy is favorable, but it might complicate surgical resection. Marking a primary tumor with radiopaque clips is essential since it facilitates accurate localization of the tumor bed and reduces the risk of breast cancer recurrence. This lecture will give an overview of imaging methods used for detection of breast cancer and evaluation of neoadjuvant therapy response including mammography, tomosynthesis, ultrasonography, and magnetic resonance imaging. Furthermore, breast interventions incorporated into the standard care of patients undergoing neoadjuvant therapy including fine- needle aspiration, core-needle biopsy, and vacuum- assisted breast biopsy will be discussed.

breast cancer, neoadjuvant therapy, breast MRI, breast imaging

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