ACR Appropriateness Criteria(®) Monitoring Response to Neoadjuvant Systemic Therapy for Breast Cancer

Journal of the American College of Radiology : JACR
Expert Panel on Breast Imaging:Mary S Newell

Abstract

Patients with locally advanced invasive breast cancers are often treated with neoadjuvant chemotherapy prior to definitive surgical intervention. The primary aims of this approach are to: 1) reduce tumor burden thereby permitting breast conservation rather than mastectomy; 2) promptly treat possible metastatic disease, whether or not it is detectable on preoperative staging; and 3) potentially tailor future chemotherapeutic decisions by monitoring in-vivo tumor response. Accurate radiological assessment permits optimal management and planning in this population. However, assessment of tumor size and response to treatment can vary depending on the modality used, the measurement technique (such as single longest diameter, 3-D measurements, or calculated tumor volume), and varied response of different tumor subtypes to neoadjuvant chemotherapy (such as concentric shrinkage or tumor fragmentation). As discussed in further detail, digital mammography, digital breast tomosynthesis, US and MRI represent the key modalities with potential to help guide patient management. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidiscipli...Continue Reading

Citations

Mar 6, 2019·AJR. American Journal of Roentgenology·Linda M SandersAvani Mehta
Apr 22, 2020·Radiology·Jung Min ChangWoo Kyung Moon
Jan 29, 2021·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Larissa A KordeDawn L Hershman
Nov 7, 2020·CA: a Cancer Journal for Clinicians·David R ByrdDonna M Gress
Aug 13, 2021·Canadian Association of Radiologists Journal = Journal L'Association Canadienne Des Radiologistes·Anabel M Scaranelo
Aug 17, 2021·Radiologic Clinics of North America·Amy M Fowler, Steve Y Cho
Sep 2, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Hannah L ChungJessica W T Leung

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