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Systematic review on accuracy of imaging techniques during neoadjuvant chemotherapy used in response-guided procedures to breast cancer subtypes and value assessment for patient, healthcare insurance company and society based on outcome indicators for breast cancer - a practical approach

Lindenberg, M (2015) Systematic review on accuracy of imaging techniques during neoadjuvant chemotherapy used in response-guided procedures to breast cancer subtypes and value assessment for patient, healthcare insurance company and society based on outcome indicators for breast cancer - a practical approach.

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Abstract:Monitoring early response to neoadjuvant (chemo)therapy (NACT) by imaging allows for an adaptative treatment approach likely to improve NACT effectiveness in breast cancer. As imaging accuracy seems to vary on tumor subtype, we aimed at creating an overview of current knowledge on the accuracy of imaging techniques in monitoring NACT for breast cancer subtypes. Furthermore, treatment options for non-respondents at imaging based were presented. By a systematic literature search we selected studies that tested imaging techniques for its prediction of pathologic complete response during NACT in breast cancer subtypes defined by the expression of HER2, ER or PR. 17 articles were selected. In HER2-negative/ER-positive FDG-PET/CT showed pooled sensitivity and specificity of 53% and 92%, whereas its use in TNBC showed 73% and 96% respectively. In HER2-positive/ER-unknown MRI showed sensitivity and specificity of 83% and 95%. In HER2-positive/ER-positive use of FDG-PET/CT showed sensitivity and specificity of 59% and 80%, whereas in HER2-positive/ER-negative FDG-PET showed 40% and 83% respectively. In HER2-positive/ER-negative, the addition of bevacizumab in non-respondents showed an improve response rate (58% vs 40%). In HER2-negative/ER-positive a switch from AC to DC could be effective in unfavourable respondents. Further research on response-guided procedures is necessary to conclude on the most effective imaging technique and potential treatment options in non-respondents to first-line treatments.
Item Type:Essay (Bachelor)
Clients:
Antoni van Leeuwenhoek, Amsterdam, Nederland
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:44 medicine, 70 social sciences in general
Programme:Health Sciences BSc (56553)
Link to this item:http://purl.utwente.nl/essays/67831
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