ArticleBreast cancer research : BCR2024
A prospective study on tumour response assessment methods after neoadjuvant endocrine therapy in early oestrogen receptor-positive breast cancer.
Article in Breast cancer research : BCR, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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9 citing papers in PubMed, 8 citations in OpenAlex.
- The Predictive Value of the Tumor-Stroma Ratio for Neoadjuvant Endocrine Therapy in Hormone Receptor-Positive Breast Cancer.International journal of cancer · 2026Article
- Multimodal imaging and artificial intelligence for response assessment to neoadjuvant therapy in breast cancer: a comprehensive review.NPJ breast cancer · 2026Review
- Neoadjuvant endocrine therapy often leads to breast and axilla-conserving surgery in stages II and III hormone receptor-positive breast cancer patients: A registry study.International journal of cancer · 2026Article
- Estrogen receptor signaling drives immune evasion and immunotherapy resistance in HR+ breast cancer.The Journal of clinical investigation · 2026Article
- Evaluation of induction chemotherapy response using multiphasic dual-energy CT in nasopharyngeal carcinoma.European radiology · 2025Article
- Molecular characterisation of the residual disease after neoadjuvant endocrine therapy in ER+/HER2- breast cancer uncovers biomarkers of tumour response.Translational oncology · 2025Article
- Article
- Patient outcomes and clinician perspectives following one year ofTranslational breast cancer research : a journal focusing on translational research in breast cancer · 2025Article
- Discovery of oxazine-linked pyrimidine as an inhibitor of breast cancer growth and metastasis by abrogating NF-κB activation.Frontiers in oncology · 2024Article
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Authors and funding
11 authors at 3 institutions in 1 country.
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Abstract
backgroundNeoadjuvant endocrine therapy (NET) in oestrogen receptor-positive (ER+) /HER2-negative (HER2-) breast cancer allows real-time evaluation of drug efficacy as well as investigation of the biological and molecular changes that occur after estrogenic deprivation. Clinical and pathological evaluation after NET may be used to obtain prognostic and predictive information of tumour response to decide adjuvant treatment. In this setting, clinical scales developed to evaluate response after neoadjuvant chemotherapy are not useful and there are not validated biomarkers to assess response to NET beyond Ki67 levels and preoperative endocrine prognostic index score (mPEPI).
methodsIn this prospective study, we extensively analysed radiological (by ultrasound scan (USS) and magnetic resonance imaging (MRI)) and pathological tumour response of 104 postmenopausal patients with ER+ /HER2- resectable breast cancer, treated with NET for a mean of 7 months prior to surgery. We defined a new score, tumour cellularity size (TCS), calculated as the product of the residual tumour cellularity in the surgical specimen and the tumour pathological size.
resultsOur results show that radiological evaluation of response to NET by both USS and MRI underestimates pathological tumour size (path-TS). Tumour size [mean (range); mm] was: path-TS 20 (0-80); radiological-TS by USS 9 (0-31); by MRI: 12 (0-60). Nevertheless, they support the use of MRI over USS to clinically assess radiological tumour response (rad-TR) due to the statistically significant association of rad-TR by MRI, but not USS, with Ki67 decrease (p = 0.002 and p = 0.3, respectively) and mPEPI score (p = 0.002 and p = 0.6, respectively). In addition, we propose that TCS could become a new tool to standardize response assessment to NET given its simplicity, reproducibility and its good correlation with existing biomarkers (such as ΔKi67, p = 0.001) and potential added value.
conclusionOur findings shed light on the dynamics of tumour response to NET, challenge the paradigm of the ability of NET to decrease surgical volume and point to the utility of the TCS to quantify the scattered tumour response usually produced by endocrine therapy. In the future, these results should be validated in independent cohorts with associated survival data.
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