Radio-pathological agreement of conventional imaging studies to evaluate therapeutic response with neoadjuvant chemotherapy in breast cancer

Background:The evaluation of pathologic response to neoadjuvant treatment by conventional methods (mastography and ultrasound) has been shown to have greater sensitivity and specificity when assessed together, since mastography has limitations in dense breasts that ultrasound improves, serving as a complementary study.Objective: The objective of this study was to evaluate the concordance of mastography and ultrasound with the histopathological report to identify tumor response to neoadjuvant systemic therapy in breast cancer.Material and methods: This was observational, longitudinal, and retrospective cohort study in breast cancer patients treated with neoadjuvant chemotherapy, with mastography, ultrasound, and histopathological report (gold standard).The response to chemotherapy was evaluated using the residual cancer burden criteria.In the statistical analysis, percentages, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and radio-pathological concordance were obtained by means of a weighted Kappa index with 95% confidence interval.Results: In 52 patients, the use of mastography combined with ultrasound has a sensitivity of 98%, specificity 67%, PPV 96%, NPV 80%, and kappa of 0.70 to identify response to treatment globally.Conclusion: Mastography and ultrasound together have good concordance with histopathologic report for predicting response to neoadjuvant treatment.